Identity questions over the borders of the human are complicated in novels such as Kazuo Ishiguro’s Never Let Me Go (2005), Ninni Holmquist’s The Unit (2006) and Neal Shusterman’s Unwind series (2007–2014), which explore the role of new biology, and new life forms, in future societies.[1] In these texts, the survival of the human depends on the incorporation of organs from other bodies: living cadavers in Ishiguro and Holmquist, and convicted teens in Shusterman. That the self/other binary blurs and even breaks down when a ‘foreign’ (hence, xeno-) organ, such as the heart, is transplanted into the body of another is now a truism, especially in the wake of nonfictional writings on the subject by Jean-Luc Nancy, Lesley Sharp, Peta Cook, and others.[2] This is reflected in the view of Donna McCormack, writing with a perspective on ethics and the medical humanities, that ‘organ transplantation may seem to be a subject that belongs to the realm of biomedicine’, but that ‘it is increasingly an area that raises urgent questions regarding the meaning of the human, our responsibility to others, care and violation, and the role of technologies in prolonging life or in furthering deadly practices’.[3] For McCormack, xenotransplantation is clearly a domain in which critical posthumanist positions cannot but find particular resonances. If ‘vitality is precisely because it is relational’, [4] then questions on self, identity, alterity, the mutually constitutive nature of ‘life itself’ and the genealogy of life that involves assimilation and cooperation across and among organisms, as well as the living/non-living divide, all find a significant place in debates around xenotransplantation. In McCormack’s words,

organ transfer brings to the fore a posthumanist ethics of vulnerability, where the human is always already of that which might be perceived as the inhuman, the dead or the inanimate. The toxicity of such a regime of care renders apparent a posthuman world of dependence on that which simultaneously harms and maintains and sometimes destroys life.[5]

What xenotransplantation enables is a recasting of the very figure or form of the human. It is inadequate to think of the body-with-transplants as simply existing in a state of relationality with those from whose body/ies the organs have been harvested. It is the very form-of-life that has been significantly altered in this state of being that qualifies as posthuman.

The phrase/concept ‘form-of-life’ is Giorgio Agamben’s. Agamben writes:

With the term form-of-life, by contrast, we understand a life that can never be separated from its form, a life in which it is never possible to isolate and keep distinct something like a bare life … A life that cannot be separated from its form is a life for which, in its mode of life, its very living is at stake, and, in its living, what is at stake is first of all its mode of life. What does this expression mean? It defines a life—human life—in which singular modes, acts, and processes of living are never simply facts but always and above all possibilities of life, always and above all potential.[6]

Form-of-life in xenotransplantation is a set of quite distinct possibilities and potentialities. Bodies that are xenotransplanted – by which we understand persons, organisms who have received organs – enable a whole new set of possible ‘forms’ and processes. Indeed, Nancy agrees that the possibility of life itself now depends in his case on the transplanted heart that he has received:

A life “proper” that resides in no one organ but that without them is nothing. A life that not only lives on [survit], but that still lives properly, within the three-fold grip of the stranger/the foreign: that of the decision, of the organ, and of the transplant’s effects.[7]

At a key moment in Ishiguro’s Never Let Me Go, one of the characters argues that for the human race to continue, in the face of cancer and such deadly diseases, the harvesting of fresh organs – and hence the controlled raising of clones as donors – is essential. Here the possibility of life itself relies on receiving healthy organs and, as Nancy also notes throughout his essay, the ability to live out the remainder of one’s life depends on this received organ continuing to be enmeshed in technological and pharmacological networks that take care of its functioning. Xenotransplantation then exemplifies the linkages that ensure that life is lived fully, if conditionally.

In the work of Ishiguro, Holmquist and Shusterman, the recipients of transplanted organs remain unnamed and unidentified. Controlled, clinical and anonymous, the practices of xenotransplantation represented in these texts delink organs from persons (both donors and recipients). The donor economy operates here on a principle of unrewarded, unreciprocated gift exchange, a principle that reflects actual practices of organ donation within society.[8] Setting aside the very real questions of consent and coercion opened up by these texts – questions concerning the quality of life of those whose organs are being harvested – these texts show us that the very state of being alive cannot be separated from the form of this life. Life is here determined by the borrowed organs, yet the organs are themselves treated as independent, unattached units even though they have been nurtured, and have helped nurture, life elsewhere.

The issues are also apparent in the case of Maylis de Kerangal’s award-winning novel Mend the Living, in which a young boy falls into a coma as a result of an automobile crash.[9] His form of life – and we are told of his energetic youth, implying the potential that his youthful body contained – effectively comes to an end when he lies connected to machines that keep his key organs (except for his brain) ticking. His organs are used to save an older woman who has, for some time now, lived with a dysfunctional heart. For this woman, the possibility of staying alive depends on (a) losing one’s native, natural, ‘own’ organ – the heart – and (b) incorporating the foreign heart. The ‘mode of living’ of the body with the transplanted organs is intimately linked to the suppression of its native immune system. Through immuno-suppressant medication, the body is tutored into accepting that which is foreign. In other words, the form-of-life is here characterised by a weakening of the very boundaries of the native body and the subversion of the very guardians that once defended its identity. This form-of-life, then, is one of shared boundaries. The receiving organism can only maintain a recognisably human form because it is no longer unitary, coherent or sovereign: inside the punctured borders is the heart of the other. For the human with diseased organs, rapidly losing sovereignty and agency, the organ transplant is what enables a minimal possibility of sovereign life, which becomes dependent upon the violation of corporeal frames.

A second alteration in the form-of-life as a result of xenotransplantation has been evocatively captured by Nancy.

[T]here comes a certain continuity of intrusion, its permanent regime: added to the more-than-daily doses of medication, and being monitored in the hospital, are the dental effects of radiation therapy, the loss of saliva, alimentary supervision as well as that of contacts that may be contagious, the weakening of muscles and kidneys, the diminution of memory and of the strength to work, the reading of medical analyses, the insidious returns of mucositis, candidiasis, polyneuritis, and the general feeling of no longer being dissociable from a network of measurements, observations, and of chemical, institutional, and symbolic connections, which do not allow themselves to be ignored, as can be those of which ordinary life is always woven. On the contrary, these connections deliberately keep life constantly alert to their presence and surveillance. I become indissociable from a polymorphous dissociation.[10]

The form-of-life here is one of polymorphic and interlinked states of being, rather than a unitary, bounded one. And Nancy has also captured powerfully how the lived experience of the interlinking is less than seamless: dissociative and estranging, rather. Already our organs, by dying, become strangers, as Nancy argues:

If my heart was giving up and going to drop me, to what degree was it an

organ of “mine,” my “own”? Was it even an organ? … It was becoming a stranger to me, intruding through its defection — almost through rejection, if not dejection … My heart was becoming my own foreigner—a stranger precisely because it was inside.[11]

 

Conversely, one’s death does not mean the death of one’s organs, which may live on elsewhere. The self is the foreigner who comes in to keep us alive, and the self continues, in an unknowable form, in the foreigner elsewhere when organs are donated. As a body dies, it lives again, synecdochally, through the invasion of the foreign. Whether this fungibility of organs renders human beings isotopes of each other is a moot point, of evident interest in posthumanist debate. What is certain is that with the expansion of biomedical technologies that defer dying and alter living states, xenotransplantation marks another layer to posthumanist visions. The existing technology – and it has existed for some time now – is adequate for the recognition that the boundedness, autonomy and coherence of human bodies and life is a myth sustained in the face of such medical and cultural practices like xenotransplantation. At the same time, concerns surrounding the affective dimensions of xenotransplantion, in both fact and fiction, cannot be minimized. What xenotransplantation then invites is reflection on its import for what Agamben envisions when he writes that ‘what we call form-of-life is a life in which the event of anthropogenesis – the becoming human of the human being – is still happening’ (208). Xenotransplantation may not quite generate the human itself, but it has a bearing on the evolving conditions for the continued happening of the human and how they are thought through.

 

 

[1] Kazuo Ishiguro, Never Let Me Go (London: Faber and Faber, 2005); Ninni Holmquist, The Unit, trans. Marlene Delurgy (New York: Other Press, 2017); Neal Shusterman, Unwind (London: Simon and Schuster, 2012).  

[2] Jean-Luc Nancy, L’Intrus, trans. Susan Hanson (Ann Arbor: Michigan University Press, 2002); Lesley Sharp, Strange Harvest: Organ Transplant, Denatured Bodies and the Transformed Self (Berkeley and London: University of California Press, 2006), Peta S. Cook, “The Social Aspects of Xenotransplantation”, Sociology Compass 71.3 (2013), pp. 237–254.

[3] Donna McCormack, “Posthumanist Ethics and Organ Transplantation”, Tidsskrift for kjønnsforskning 2 (2014), pp. 173–178. Cited from p. 173.

[4] McCormack, p. 177, emphasis in original.

[5] McCormack, p. 177.

[6]  Giorgio Agamben, The Uses of Bodies. Homo Sacer IV.2, trans. Adam Kotsko (Stanford: Stanford University Press, 2016), p. 207, emphasis in original.

[7] Nancy, p. 8.

[8]  See Margaret Lock, Twice Dead: Organ Transplants and the Reinvention of Death (Berkeley: University of California Press, 2002), p. 50.

[9] Maylis de Kerangal, Mend the Living, trans. Jessica Moore (London: MacLehose, 2016).

[10] Nancy, p. 12.

[11] Nancy, pp. 3–4.