‘Transplantation Gothic’: Book Review

Elizabeth Hornsey reviews Transplantation Gothic: Tissue transfer in literature, film and medicine (Manchester University Press, 2020) by Sara Wasson.

Medicine and the study of literature are, I argue, engaged in a very similar set of ventures: that is, the exploration of one of nature’s most intricate books: the human body and all that comes along with human embodiment. The medical humanities and Gothic studies are two particular strains of literary criticism particularly concerned with the interconnectedness of bodies and texts. Gothic corporeality has been effectively unpacked previously by other scholars in order to explore or historicize the messy and often grotesque potential of the human body (see Mulvey-Roberts 2018, Aldana Reyes 2014). Cultural and legal discussions of the ethics of organ and tissue transplantation procedures struggle to convey their full complexity. In response, multiple projects have been mounted by medical humanities scholars to grapple with different cultural facets of these procedures, such as the affective challenges of receiving heart transplants or being the family of a heart donor (El-Sheikh 2020), or how cultural representations can reveal the ‘ideological violations’ that had to be overcome before organ transplantations could become widely socially accepted and praised (Russell 2019). Sara Wasson’s Transplantation Gothic, published by Manchester University Press, enters what might be termed the ‘transplantation studies landscape’ with an intriguing critical proposition: what if one grafted together Gothic studies and the medical humanities to create a new methodology for studying tissue transfer representations that blends Gothic studies’ nuanced understanding of fears about scientific overstep and the fragility of bodies with the humanistic approach to medicine done within the medical humanities. This new methodology seeks to create an interdisciplinary “boundary practice” (mirroring how Wasson describes tissue transfers) that assembles and analyzes a nuanced “shadow cultural history of transplantation” (Wasson 2020, 2).

While it might not be immediately apparent to readers how compatible the combination of transplantation and gothic is to readers, Transplantation Gothic’s introductory chapter makes a strong case for the usefulness of the critical tools Gothic studies has to offer future work within the medical humanities. Wasson utilizes a deeply interdisciplinary method in her introduction, drawing upon Gothic studies, medical humanities, historicist criticism, and other interdisciplinary work, which includes one of the book’s most effective conceptual frameworks, ‘slow violence’ (Nixon 2013), a term used to describe violence that occurs gradually and often out of sight, such as the incremental effects on health and land caused by climate change or the environmental costs of war. This introduction extends Wasson’s previous work on combining Gothic studies and the medical humanities (Wasson 2015:1-12) and brings it to bear on the specific uses of considering Gothic texts and using Gothic studies’ modes of critical engagement to consider both the representations and realities of transfer procedures. Wasson’s introduction takes the time to carefully establish her reasoning behind the terminology and concepts employed within the book: transfer instead of transplantation, the Gothic ‘mode’, and ‘the body’ are all unwound for the reader and their critical utilities and rhetorical instabilities are discussed at length. This chapter lays the groundwork for the ways the Gothic mode (and genre) will contribute to the approach of the book and the texts selected for analysis by expanding our understandings of how we conceptualize bodies in flux and how representations of tissue transfer can foster either fears about medical misconduct or confidence in medicine’s progress— and makes a convincing case for how this grafting could hopefully extend into other medical humanities scholarship.

Chapter 1 of Transplantation Gothic immediately gets to work defining what Wasson terms a ‘clinical necropoetics’ in existing scientific and medical writings about both tissue transplantations and death. The Gothic discursive, this chapter argues, features prominently in clinical transplantation rhetorics. Wasson suggests that attending to the Gothic mode (identifiable by the use of sensual, rich language and evocative imagery meant to create affective response in a reader)  in scientific and medical prose across several decades indicates very clearly that these writings serve as sites at which scientists’ and clinicians’ uncertainties and affective struggles around defining clinical ‘death’, which also dictates suitability for tissue donation, can be located. Much of this chapter is spent unpacking the lengthy and often emotionally inflected history of clinical death, which encompasses ambiguously defined terms like brain stem death, whole-brain death, and chronic disorders of unconsciousness. Once this history has been established, the chapter analyzes how Gothic imagery and intertextualities are utilized in these scientific writings to manage corporeal ambiguities, either negatively by emphasizing the ambiguity of death and ‘undeath’, or positively by emptying them of their horrors, depicting ‘good’ scientific progress under threat by those who do not understand the work being done.

Chapter 2, titled ‘The Bioemporium’, takes on a discussion of the intricacies of fictional responses to transfer economies and capital, deftly analyzing the corporate medical horror genre on a Gothic reading of texts chosen from American ‘70s and ‘80s transplantation fiction. The second chapter turns to, among a handful of other texts, an analysis of Cook’s novel Coma and related films, charting their use of Gothic modes and the measurable, lingering effects Cook’s novel had on social views about becoming an organ donor. This chapter concludes with a discussion of how each of the texts in this chapter can be read as anxious or speculative Gothic fictions that address fears of transfer economies influenced by greed and capital, or perhaps as so ridiculously mired in body horror that they normalize the more genuine horrors that do exist in donor pool inequalities and transfer access.

Chapter 3 then turns to discuss these inequalities, their representations, and their locations and realities on a global scale. This is where Wasson’s admirable dedication to what Belcher terms “citation values” (Belcher 2019:161) is most apparent in Transplantation Gothic. This chapter utilizes a few American texts in conversation with Manjula Padmanabhan’s play Harvest to discuss the myths surrounding when and where the (actual) exploitations involved in transfer assemblages take place–relocating them from the fantasies about transfer economies in the Global South and rightfully placing them in their lived realities in Western medicine, often misrepresented or elided our unwillingness to address medical inequities by considering who is most frequently a donor versus a transfer recipient. This chapter makes excellent use of slow violence to address two extended temporalities of neocolonial and anti-Black violence in transfer economies: systemic slow violence and the unwilling supplier’s suffering before, after, and during transfer.

Chapter 4 seeks to reapply slow violence and corporal ambiguity to our reoccurring representational fantasies about donor transfer tissue altering recipients in meaningful and sometimes horrifying ways. Gothic studies is particularly salient here, as themes like possession and paranoias and well as a mysterious past come back to haunt the recipients are features of each text discussed. This chapter builds a framework utilizing Derrida and Deleuze and Guattari, in cooperation with a wide and well-utilized variety of critical tools spanning from feminist sociology to psychoanalysis, to articulate the unique position of the transfer tissue recipient in an intricate web of transfer-involved parties, and further extends this to frame an imaginative corporal enmeshing between donor and recipient that is often downplayed or discouraged by the medical rhetorics surrounding acceptable donor responses to transfer.

Image source: https://www.metmuseum.org/art/collection/search/358129

Chapter 5 then very naturally moves to instead think through dystopian fictions centered on the (often unwilling) donor experience, using earlier discussions about state and capitalist interests in transfer economies to move through a handful of well-chosen texts that are all arguably speculative fictions, grouped by time period in order to demonstrate a shift in how donor response to their plights changed with distance from the first successful transplantation. Tracing this trajectory while focusing on a shift in how the donors experience their dystopias and ‘harvest’ also allows Wasson to utilize Halberstam’s concept of “queer time”, or uses of time and space that are in opposite to typical timelines of family life, heterosexuality and sexual reproduction, in novel ways while also returning again to her anchoring use of slow violence as a conceptual touchstone for the book. The book then ends with a brief coda centered around a consideration of Vesalius’ De Humani Corporis Fabrica and the implications that images of bodies opened in perpetuity has for the running themes of slow violence and never-healing wounds in Transplantation Gothic— a fitting ending for a book concerned with exploring the raw contours of a procedure with no pinpointable ‘recovery’, a body forever necessitating care.

The concepts and interdisciplinary collaboration between Gothic studies and the medical humanities that structure Transplantation Gothic present wonderful possibilities for models of future scholarship, and how Gothic modes might be used to consider other medical humanities concerns. Humans desire easy stories, narratives with an obvious end—and Wasson’s book provides us with a framework to explore the uneasy temporality and topographic anatomy of wounds without resolution. This book presents itself at a time where a pandemic has rendered many of us increasingly unfamiliar with our own bodies and, in some cases, new chronic illnesses with no resolution in sight. This book provides a necessary and timely intervention into (re)considering the slow violence(s) wrought upon our own bodies and communities.

References 

Aldana Reyes, Xavier. 2014. Body Gothic: Corporeal Transgression in Contemporary Literature and Horror Film. Cardiff: University of Wales Press.

Belcher, Wendy Laura. 2019. Writing Your Journal Article in Twelve Weeks: A Guide to Academic Publishing Success. Chicago: University of Chicago Press.

El-Sheikh, Tammer. 2020. Entangled Bodies: Art, Identity and Intercorporeality. Wilmington: Vernon Press.

Halberstam, J. Jack. 2005. In a Queer Time and Place: Transgender Bodies, Subcultural Lives. New York City: NYU Press.

Mulvey-Roberts, Marie. 2017. Dangerous Bodies: Historicising the Gothic Corporeal. Manchester: Manchester University Press.

Nixon, Rob. 2013. Slow Violence and the Environmentalism of the Poor. Boston, Massachusetts. Harvard University Press.

Russell, Emily. 2019. Transplant Fictions: A Cultural Study of Organ Exchange. Cham, Switzerland: Palgrave Macmillan.

Wasson, Sara. 2015. Useful Darkness: Intersections between Medical Humanities and Gothic Studies. Gothic Studies. 17(1): 1-12.

Wasson, Sara. 2020. Transplantation Gothic. Manchester: Manchester University Press.

Elizabeth Hornsey is a PhD candidate at the University of Cincinnati. Her dissertation is a cultural history of facial difference and facial transplantation and reconstruction in literary texts and other cultural texts. She has a forthcoming book chapter in The Rail, the Body and the Pen: Essays on Travel, Medicine and Technology in 19th Century British Literature on the influence of developments in medical technology and gynecology in Carmilla. Find Elizabeth on Twitter @brokengargoyles.

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