In truth, each text explores living rather than cadaveric procurement, since that configuration makes the negotiation of consent all the more challenging. I am interested in the kinds of language and symbolic substitution that legitimate tissue transfer. In each case, I examine the kinds of bodies that are rendered harvestable and the spatial locations constituted for the removal of tissue.
The moment of harvest — and the accompanying symbolic “disentanglement” — is often presented as occurring in a kind of ceremony in a particular, bounded space. Each of these dystopian fictions imagines a society in which some people are taken aside into spaces marked off from ordinary life, and then have their bodies recategorised for harvest. Paul-Michel Foucault’s notion of “heterotopia” is pertinent here, describing as it does sites marked off from the everyday world where transformations can occur. Each novel features what we might call a “harvest heterotopia”: usually a blend of hospital or prison, but sometimes also with touches of a festival site. Time often functions oddly within a heterotopia. Paul-Michel Foucault offers the term “heterochronies” to describe these different modes of time within a heterotopia, such as “the heterotopias of the eternity of accumulating time”, e.g. museums and libraries, “in which time never stops building up and topping its own summit”, or “the heterotopia of the festival”, in which a space becomes a heterotopia only at particular times. One might also speak of a heterochrony of illness experience. Rita Charon notes that time is experienced differently for patient and doctor: “When the doctor or nurse enters the room to do something he or she remains within vectored time, that is, a state of time in which one event leads to another and can even be conceptualized as having caused it while the patient inhabits a timeless enduring.”
The donor-victims in these dystopian texts inhabit exactly such a strange state of enduring, their agency suspended and the passage of time being simultaneously a reprieve (since they are still alive) and torture (since they await vivisection).
Richard Shusterman’s ‘Unwind’ is the first of the ‘Unwind Dystology’, four novels and a novella; I will confine my discussion to the first, but the sequels are also of great interest. ‘Unwind’ was inspired by a real-life case of a Ukrainian orphanage which became a target for black market organ procurement. The novel imagines a future America in which a civil war between pro-life and pro-choice forces has transformed medical practice. Peace was reached through a “Bill of Life” which forged a compromise on abortion. If parents choose, when their child is aged between thirteen and eighteen, the child can be “unwound”, every piece of their tissue transplanted to a different human recipient.
Transplant is unapologetically commercialised in this imagined society, and all unwound tissue must be paid for. In a triumph for the private sector, these “Harvest Camps” are privately-owned, profit-making facilities, sustained by government investment. As one character notes, “Once the unwind orders were signed, we all became government property.” When one character asks a camp counsellor what happens with organs that are not good calibre, she is told, “a deaf ear is better than no ear at all, and sometimes it is all people can afford.”
This explicit commodification of human tissue is underpinned by an extensive series of rationales in this imagined society. First, the economic “disentanglement” is made possible through the language used to classify the two categories of a harvestable body. Most often, these are juvenile delinquents: the transgressive body is a harvestable body. Yet Richard Shusterman’s novel offers a second, contradictory category: in a few cases, some religious parents choose to “tithe” a child, marking a child from birth as destined to be unwound. These labels change the sovereignty of these categorised bodies.
This society handles the contradictions of “gift” and “waste” through an ingenious rationale of the harvest process: it is held that consciousness persists even after the tissue is unwound, so procurement does not result in true death. ‘Unwinds’ are kept conscious throughout the dismemberment (locally anaesthetised), and after dismemberment and transplant are described as “living in a divided state.” Characters marked for ‘Unwinding’ contemplate this notion with horror: one imagines it as being “unwound into nothing — his bones, his flesh, his mind, shredded and recycled.” The novel simultaneously mocks and endorses the notion of “living in a divided state” after harvest. On the one hand, the idea is mocked as absurd: one character is told by a harvest camp counsellor that she will not be 100% alive, but “actually 99.44 percent, which takes into account things like the appendix.” On the other hand, the novel presents multiple examples of transplant tissue indeed somehow altering the recipient. A trucker who received a transplanted arm says, “These fingers here knew things the rest of me did not. Muscle memory, they call it.” When another character receives Unwind tissue, the nurse warns him “Parts often come with their own personalities.” The most harrowing example of this ongoing life is the case of the character CyFi, a teenager who received Unwind brain tissue. CyFi explains, “It is like those ghosts who do not know they are dead. He keeps trying to be him, and can not understand why the rest of him is not there.”
The novel even culminates in a re-assembling of unwound tissue where the penitent parents of one Unwind, Harlan Dunfee, gather all the recipients of his tissue for his twenty-sixth birthday, “putting their son together in the only meaningful way they can.” Harlan Dunfee speaks to his parents at the end, all the recipients uniting their conversations, and his parents welcome him home. The extraordinary upshot of these moments endorsing the idea of “living in a divided state” is that they unmask the horror of the initial commodification of the tissue. In other words, in this fictional world at least, tissue alienation is far from easy.
A second interesting consequence of this narrative element is the way it subtly challenges the premise that consciousness and the body can be divorced, an assumption central to contemporary Western transplant practice. To date, real-life tissue transplantation technologies have tended to reinforce the idea that identity can be reduced to a neural locus: Donald Joralemon notes that “Transplantation surgeries contribute to conceptions of the body as a collection of replaceable parts and of the self as distinct from all but its neural locus.” Harvest fictions like ‘Unwind’, which connect consciousness with tissue other than that governing higher brain functions, offer a subversive alternative vision of the intersection between body and mind.
In Unwind’s society, the primary narrative of procurement is of wasted lives being redeemed by medical intervention. That fictional discourse parallels some ethnographic evidence from today’s real procurement environments: Sharp has identified a minority but very real strand in donor-kin facing procurement discourse in America, which tries to support donor kin to agree to cadaveric donation with the view that a “wasted” life — perhaps one seen by donor kin as morally problematic — can be redeemed by the procurement. That poignant and controversial strand of procurement discourse has some echoes in this novel. As soon as the character Roland — a violent teenager with criminal past — begins undergoing procurement surgery, strapped to a table and his blood being drained from his veins, a nurse tells him, “Not a bit gets wasted. You can bet, you will be saving lives!.” Even some of the Unwinds themselves subscribe to this view: as “Samson” says in the epigraph to the first chapter, “I was never going to amount to much anyway, but now, statistically speaking, there’s a better chance that some part of me will go on to greatness somewhere in the world. I’d rather be partly great than entirely useless.”
The site where Unwinding occurs is a hybrid heterotopia, a blend of hospital and festival site: a holiday camp. Simultaneously festive and carceral, it embodies the ambivalence that accompanies the paradoxical construction of harvest in this society. The process of Unwinding is presented as a ceremony. We are told that, “The harvesting of Unwinds is a secret medical ritual that stays within the walls of each harvesting clinic in the nation”, but Richard Shusterman takes us into the ritual, using third person present tense narration to describe the horror of being dismembered alive, in a society where that horror is tamed by a calm, clinical, socially-justified narrative.
The present tense makes the actual Unwinding of the character Roland all the more disturbing to read. He is given local anaesthetic but remains conscious throughout. He is strapped to a table. He can hear people dropping instruments, but cannot see what they are doing: “Surgeons leave, new ones arrive. The new ones take an intense interest in his abdomen. He looks towards his toes but can not see them. Instead, he sees a surgical assistant cleaning the lower half of the table.” Statements of prepackaged sympathy come from the nurse, interweaved with the dialogue of surgeons dismembering: the nurse tells him she is sure he was a good son, while the surgeon calls “scalpel.” There is simultaneously a callousness and bizarre tenderness to the process: the medical staff “wear scrubs the colour of a happy-face’; his arms and legs are bound, and ‘A nurse blots sweat from his forehead. “Relax, I’m here to help you through this”. Greening metaphors tame the procurement throughout transplant is always called “grafting”, Unwinding is “harvest”, and one of his final sights (before they remove his eyes) is of the surgical staff as themselves a kind of flower: “Yellow figures lean all around him like flower petals closing in.”
The novel presents a heterochrony in the harvest process. Throughout, we are given repeated prompts about the clinical timespan of the procedure. An hour or so into the procurement, for example, Roland hears “A clanging of metal. The lower half of the table is unhooked and pulled away.” One hour and forty-five minutes in the nurse says he wo not be able to talk anymore — they are taking his lungs. Two hours and five minutes in he can only communicate by blinking, and “Another section of the table is taken away.” The description of the procurement surgery is repeatedly punctuated by a litany of clinical durations. Yet there is a tension between these clinical markers of time and the narration itself, which regularly interrupts that clinical time sequence, freewheeling into the harvester’s past experience and childhood trauma and moments he was deprived of love. “Memories tweak and spark. Faces. Dreamlike pulses of light deep in his mind. Things he has not thought about in years. The memories blood, then they are gone.” An entire lifetime of suffering is compressed into the surgical sequence.
Also published on Medium.