Pearsall is not a doctor, or not, at least, one of the medical variety. He is a doctor of the variety that gets a Ph.D. and attaches it to his name on self-help book covers. I found his testimonials iffy as evidence of any sort of “cellular” memory, based as they are on crude and sometimes absurd stereotypes: that women become prostitutes because they want to have sex all day long, that gay men—gay robbers, no less—like to dress in feminine clothing. But bear in mind that I am, to quote item 13 of Pearsall’s Heart Energy Amplitude Test, “cynical and distrusting of others’ motives.”
Mehmet Oz, the transplant surgeon I spoke with, also got curious about the phenomenon of heart transplant patients’ claiming to experience memories belonging to their donors. “There was this one fellow,” he told me, “who said, ‘I know who gave me this heart.’ He gave me a detailed description of a young black woman who died in a car accident. ‘I see myself in the mirror with blood on my face and I taste French fries in my mouth. I see that I’m black and I was in this accident.’ It spooked me,” says Oz, “and so I went back and checked. The donor was an elderly white male.” Did he have other patients who-claimed to experience their donor’s memories or to know something specific about their donor’s life?
He did. “They’re all wrong.”
After I spoke to Oz, I tracked down three more articles on the psychological consequences of having someone else’s heart stitched into your chest. Fully half of all transplant patients, I found out, develop postoperative psychological problems of some sort. Rausch and Kneen described a man utterly terrified by the prospect of the transplant surgery, fearing that in giving up his heart he would lose his soul.
Another paper presented the case of a patient who became convinced that he had been given a hen’s heart. No mention was made of why he might have come to believe this or whether he had been exposed to the writings of Robert Whytt, which actually might have provided some solace, pointing out, as they do, that a chicken heart can be made to beat on for several hours in the event of decapitation—always a plus.
The worry that one will take on traits of the heart donor is quite common, particularly when patients have received, or think that they have, a heart from a donor of a different gender or sexual orientation. According to a paper by James Tabler and Robert Frierson, recipients often wonder whether the donor “was promiscuous or oversexed, homosexual or bisexual, excessively masculine or feminine or afflicted with some sort of sexual dysfunction.” They spoke to a man who fantasized that his donor had had a sexual “reputation” and said he had no choice but to live up to it. Rausch and Kneen describe a forty-two-year-old firefighter who worried that his new heart, which had belonged to a woman, would make him less masculine and that his firehouse buddies would no longer accept him. (A male heart, Oz says, is in fact slightly different from a female heart. A heart surgeon can tell one from the other by looking at the ECG, because the intervals are slightly different. When you put a female heart into a man, it will continue to beat like a female heart. And vice versa.)
From reading a paper by Kraft, it would seem that when men believe their new hearts came from another man, they often believe this man to have been a stud and that some measure of this studliness has somehow been imparted to them. Nurses on transplant wards often remark that male transplant patients show a renewed interest in sex. One reported that a patient asked her to wear “something other than that shapeless scrub so he could see her breasts.” A post-op who had been impotent for seven years before the operation was found holding his penis and demonstrating an erection. Another nurse spoke of a man who left the fly of his pajamas unfastened to show her his penis. Conclude Tabler and Frierson, “This irrational but common belief that the recipient will somehow develop characteristics of the donor is generally transitory but may alter sexual patterns….” Let us hope that the man with the chicken heart was blessed with a patient and open-minded spouse.
The harvesting of H is winding down. The last organs to be taken, the kidneys, are being brought up and separated from the depths of her open torso. Her thorax and abdomen are filled with crushed ice, turned red from blood. “Cherry Sno-Kone,” I write in my notepad. It’s been almost four hours now, and H has begun to look more like a conventional cadaver, her skin dried and dulled at the edges of the incision.
The kidneys are placed in a blue plastic bowl with ice and perfusion fluid. A relief surgeon arrives for the final step of the recovery, cutting off pieces of veins and arteries to be included, like spare sweater buttons, along with the organs, in case the ones attached to them are too short to work with. A half hour later, the relief surgeon steps aside and the resident comes over to sew H up.
As he talks to Dr. Posselt about the stitching, the resident strokes the bank of fat along H’s incision with his gloved hand, then pats it twice, as though comforting her. When he turns back to his work, I ask him if it feels different to be working on a dead patient.
“Oh, yes,” he answers. “I mean, I would never use this kind of stitch.” He has begun stitching more widely spaced, comparatively crude loops, rather than the tight, hidden stitches used on the living.
I rephrase the question: Does it feel odd to perform surgery on someone who isn’t alive?
His answer is surprising. “The patient was alive.” I suppose surgeons are used to thinking about patients—particularly ones they’ve never met—as no more than what they see of them: open plots of organs. And as far as that goes, I guess you could say H was alive. Because of the cloths covering all but her opened torso, the young man never saw her face, didn’t know if she was male or female.
While the resident sews, a nurse picks stray danglies of skin and fat off the operating table with a pair of tongs and drops them inside the body cavity, as though H were a handy waste-basket. The nurse explains that this is done intentionally: “Anything not donated stays with her.” The jigsaw puzzle put back in its box.
The incision is complete, and a nurse washes H off and covers her with a blanket for the trip to the morgue. Out of habit or respect, he chooses a fresh one. The transplant coordinator, Von, and the nurse lift H onto a gurney. Von wheels H into an elevator and down a hallway to the morgue. The workers are behind a set of swinging doors, in a back room.
“Can we leave this here?” Von shouts. H has become a “this.” We are instructed to wheel the gurney into the cooler, where it joins five others.
H appears no different from the corpses already here.[33]
But H is different. She has made three sick people well. She has brought them extra time on earth. To be able, as a dead person, to make a gift of this magnitude is phenomenal. Most people don’t manage this sort of thing while they’re alive. Cadavers like H are the dead’s heros.
It is astounding to me, and achingly sad, that with eighty thousand people on the waiting list for donated hearts and livers and kidneys, with sixteen a day dying there on that list, that more than half of the people in the position H’s family was in will say no, will choose to burn those organs or let them rot. We abide the surgeon’s scalpel to save our own lives, our loved ones’ lives, but not to save a stranger’s life. H has no heart, but heartless is the last thing you’d call her.
33
Unless H’s family is planning a naked open-casket service, no one at her funeral will be able to tell she’s had organs removed. Only with tissue harvesting, which often includes leg and arm bones, does the body take on a slightly altered profile, and in this case PVC piping or dowels are inserted to normalize the form and make life easier for mortuary staff and others who need to move the otherwise somewhat noodleized body.