Sita Maria Kattanek, Carl Hanser, Munich
This study will look at dramatic representations of organ transplants because contemporary plays address the more subterranean fears surrounding the medical endeavor called transplantation. The conflicts of the dramas have their origin in debates that took place among bioethicists. The theater, however, “becomes the domain where the debate is acted out before a live audience” (Belli 2008: xiv), thus rendering the involved questions visible in a public setting. Dea Loher’s Hände (2002) and Tomio Tada’s The Well of Ignorance (1991)use the dialogical quality of drama to reveal the absurdities and grotesqueness of modern medical technologies. With emotional discomfort these plays question what it means to receive a donated body part and whether it is justified to endlessly repair the human body.
[Keywords: transplantation, Dea Loher, Hände, Tomio Tada; The Well of Ignorance; dialogical, human body]
Without release from the endless agony of my karma,
My soul can have no rest.
(The Well of Ignorance)
The past hundred years have seen many spectacular scientific breakthroughs (see Roos 2008: 41), with achievements in biotechnology being perhaps the most noteworthy ones (Friebe 2012: 64). In an interview with Wired, Bill Gates even claimed that if “he were a teenager today, […] he’d be hacking biology” (Levy 2010). Among the greatest advancements is organ transplantation, “a thrilling new option of modern surgery yielding hope for chronically ill patients” (Schicktanz et al. 2010: 3). Through its practical application, along with its financial and political implications, transplant medicine has had an unequalled influence on essential questions of life.
With very few plays written on organ transplants, two plays written around the turn of the millennium come into view – one German and one Japanese – that both belong to the so-called ‘rejection front’. The inspiration for Tomio Tada’s play The Well of Ignorance was a 1968 lawsuit in which the Japanese cardiac surgeon Dr. Juro Wada was accused of murder. The ‘transplant play’, Tada’s debut, was first performed in 1991 at the National Noh Theater in Tokyo.Contributing to a particularly emotional public discourse, the play garnered a great deal of interest (Sanger 1991a) when first staged.This is unsurprising given Japan’s resistance to adopt transplant technology. With the very first heart transplant in Sapporo (1968) and its critical media coverage, there arose a public debate on a scale unparalleled in any other nation. This discourse, whose prominence in the public eye fluctuated over time, continued for many years. The play can therefore be read as an “allegory” (Lock 1995: 7) for a larger national debate.
Dea Loher’s Hände [Hands] belongs to a series called Magazin des Glücks [Warehouse of Fortune] that was staged in Hamburg’s Thalia theatre.Analyzing the psychological difficulties of the individual confronted with organ transplantation, the play seems to have been influenced by the Clint Hallam case. Hallam volunteered in 1998 for one of the first hand transplants and received the donation from a deceased motorcyclist. Later, he asked the doctors to remove the new appendage, as he did not feel comfortable with the hand of a stranger.Speaking aboutforms of transplantations that from a medical perspective are neither necessary nor life-saving, the play attacks the commodity culture that strips organs of their value.
In the The Well of Ignorance[i], a Japanese fisherman and his crew experience a serious storm in which the former is knocked unconscious. As brain death is almost indistinguishable from a coma, the man found washed up on the seashore is mistakenly assumed to be brain-dead. Doctors consider him the perfect organ donor for a young woman suffering from heart ailments. “His soul has left this world forever. / Only his body remains on earth / With his heart beating feebly. If we leave him here to die / All will be lost” (The Well of Ignorance [TWoI] 1994 I). The young woman, who is the daughter of a rich merchant, has “developed a serious heart disease” in her “eighteen[th] year” and can “no longer leave her bed” (TWoI I). A foreign doctor is called in to remove the heart of the fisherman and perform the transplant. “Then as now this woman’s position in the upper echelons of financial mobility made such a critical operation feasible” (Jennings 1994: 56).
Though the difficult operation saves her life and she “lived happily for a while” (TWoI I), the woman later regrets what was done. She is “plagued by a guilty conscience” (TWoI I) at the drastic measures taken to restore her health. “How can it be my life was saved / By taking the heart from a living man?” (TWoI I). And while the young woman grapples with the guilt of having received a new heart, the ghost of the fisherman hovers over the play. Without his heart he is unable to fully die and remains a “vengeful spirit” (TWoI I) who is “caught between the worlds of the living and the dead” (Gellene 2010: 11). Act II begins with his sorrowful lament: “In this desolate place / Is it only beasts that hunt for bodies in empty graves? / No! I, too, am wandering in the moonlight, / Seeking my separate body. / Am I of the living or the dead?” (TWoI II). With both donor and recipient haunted by their respective states of being, the drama ends, leaving open the question of how the conflict can be overcome.
In Tada’s work, it is primarily the fate of the donor that is scrutinized. Both the play’s opening and the final scene with the chorus on stage emphasize the underlying notions of theft, cruelty and unnaturalness: “The woman lived a while longer, it is true. But, then […] she died after all…” (TWoI II).Tada’s work of fiction thus emphasizes “the intractable paradoxes and defeats that techno-science leads to” (Csicsery-Ronay 2006: 148) by showing a collision between pure science and cultural tradition. Traditionally, dying is considered in Japan as a process bridging different spheres (see Lock 1995: 21) and Japanese people regard the equivalence of death and the cessation of brain activity therefore as ‘unnatural’ and ‘contrary to basic human feelings’ (see Hirosawa 1992). Instead they believe that a person dies slowly, with the spirit gradually leaving the body and the earthly world. Moreover, many Japanese subscribe to the idea of the body as a “unique microcosmic unit embedded in the larger cosmic order” (Lock 1995: 22). And it is this notion that demands careful treatment of the body.
The conflict between applied medical technology and traditional ways of life is also visible in the tension between the drama’s content and its form.The Well of Ignorance is a Noh play – a theatrical form mostly unknown to Western audiences, although Bertolt Brecht, William Butler Yeats and Ezra Pound (Cuddon 1998: 549) adapted it for experimental purposes. Noh is a highly stylized form (see Terasaki 2002: ix) deriving from the 14th century and exploring the relationship between the “world of spirits and earthly life” (Lock 1995: 7). In its classical form, it is a drama with music furnished by a chorus and chanters accompanied by traditional instruments. “Noh characters themselves are often the spirits of the dead, appearing in fearsome wooden masks and chanting their poetic dialogues to the heavy beat of drums” (Sanger 1991b). David Mikics defines Noh as a “brief Japanese dramatic form drawing on poetry, prose, dance and music” (2007) that can be compared to the ancient Greek tragedy. Originating from both folk and aristocratic art forms, Noh performances are rather minimalistic in style, while at the same time highly “ritualistic and codified” (Terasaki 2002: x). The actors, all male, wear masks and decorated costumes and perform without having practiced more than once together. The play’s interest derives primarily from the power of its content and symbolism (see Terasaki 2002: x), rather than from the facial expressions or spontaneous emotions of the actors. Similarly, the stage is spare and the singing involves a limited tonal range but is poetic and complex in its content (see Terasaki 2002: ix).
As one might deduce from the above information, Noh is a rarely used form when dealing with biotechnological questions. Accordingly, journalist David Sanger’s tone is one of surprise in his review of the first performance of The Well of Ignorance in Tokyo: “But if the usual plots of Noh plays are drawn from ancient Japanese legends, Tada’s play emerged from the operating room” (1991a). Apart from its modern content, however, the play contains all the elements one would expect from a typical Noh work, starting with a spirit that hovers over the earthly world, a chorus and an unresolved ending.
Indeed, The Well of Ignorance is a modern play in an ancient disguise, which enables the work to build a bridge between Japan’s past and present. The audience is reminded that Japan is quintessentially different from many other countries in that it represents a “technologically sophisticated, highly literate, economic superpower”(Lock 1996: 142) that was drawn toward the modern West in certain respects, but at the same time went to great lengths to preserve a strong cultural heritage. Transplantation is thus portrayed as a sort of cultural interloper, intervening in and transforming many aspects of human existence. In choosing Noh, Tada was able to infuse his play “with mystical and nostalgic associations” (Lock 1996: 144). In Sanger’s words: Tada effectively uses an “old art form to tap a deep modern sense of ambivalence” (Sanger 1991a) – the ambivalence about what it means to be human. Fusing disparate form and content, the play succeeds in convincing its audience that the question at stake is indeed a very old one: transplantation provokes question of the boundaries between life and death, between body and spiritual soul, between the material and the intangible value of body parts.
Hände[ii]by the German playwright Dea Loher, by contrast, concentrates on the psychological difficulties of the individual confronted with organ implantation. Yet these individual concerns reveal as well something about the culture they sprung from. To further illustrate this I would like to elaborate on Hände.Two women and two men are present on stage, all of whom are anonymous, distinguished only by a number. The setting is non-specific, as are two characters that appear on stage almost without speaking. They are called Killer (Unbekannter toter Mörder [unknown dead murderer]) and Untomo (Unbekannter toter Motorradfahrer [unknown dead motorcyclist]). The play begins in medias res with Man #2 explaining how he lost something due to an accident with a saw. Calling the lost object “my old one” (Hände 31), the man leaves the audience to guess whether he is talking about his hand or maybe even his wife, whom he deprecatingly calls old.
The next time the two men meet, the former amputee proudly recounts how he has received an organ donation. Like other organ recipients and maybe even the woman in Tada’s play, he is thrilled by the immediate change after the operation. Euphorically he describes the way in which he was able to skip the waitlist (Hände 38): “How I have fought for it. / And indeed, / so much can I say / already. / No comparison. / Everything will be fine. / Everything will be much better. /Everything will be different” (Hände 38 f.) With the reception of the new donor hand, the fissure between imperfect reality and perfect self-image has been healed – at least temporarily.
Connected to the transplant, however, are expectations that seem inappropriately high – expectations of ‘progress’, ‘self-discipline’ and, above all ‘happiness’ (Hände 39). The recovery of his tactile sensations seems to mark a significant turn in the man’s life: He speaks of ‘growth’ – referring to the regeneration of nerves – claiming that his cells grow faster than those of an embryo (see Hände 39). Yet the disappointment is soon to arrive, as the transplant cannot fulfill all the expectations projected onto it. The donated hand remains a foreign object that does not work in accordance with its owner’s lofty demands.
Feelings of enthusiasm thus turn abruptly into skepticism: “So little do they belong to me, / I recoil when I accidentally lay eyes upon them” (Hände 51).The relationship between Man #2 and his hand suffers tremendously when the man thinks about his donor and begins to believe that a murder-gene might penetrate his body and affect his behavior. With the donor’s history kept under wraps, the man resorts to wild speculation. In an existential howl, he screams that he has lost “all control” (Hände 52) over his life. Misleading ideals of happiness have turned him into an emotional cripple. He suffers from the transplant, yet in contrast to Tada’s heart recipient his concerns appear completely egotistical, as no pity for the donor is ever expressed. Instead, the transplant becomes the object of projection for his failed dreams.Outside this vacuum of self-absorption, there is nothing of relevance for him.
In the play’s final scene, he asks Man #1 to cut his transplanted hand off. His maniacal pursuit of perfection has brought him only misery. The real happiness he was searching for, however, has not materialized. Within this last scene, his language again points to a spiritual vacuity: In the absence of profound beliefs, “everything becomes invested instead in this life, in this body” (Dickenson 2008: 152).The metaphysical message becomes obvious when Man #2 declares that he had trusted in modern medicine and had believed that “EVERYTHING” (Hände 31) would be all right. This quotation shows that beneath the personal crisis, of course, lies a philosophical crisis: Living in an oversaturated consumer society where everything is possible and stripped of any real ideals, Man #2 has come to associate the emotion of happiness with physical superiority alone.
Loher’s play, much like Tada’s, leaves an exasperated person on stage. Both, donor and recipients suffer – and Tada’s title implies that only those who are ignorant of transplantation’s implications will feel well – a little jab at those countries, where the ethics of organ removal are often subordinated to the successful implantation of the organ. With The Well of Ignorance, Tada presents his insight into the “malaise of modernity” (Lock 1997: 132) as a universal warning of uncontrolled technical progress. But Loher’s play also contains many utterances that should make any Western audience prick up their ears.Man #2’s decision mirrors that of the consumer who goes into a shop and wants to buy himself a brand item to make his life better as promised by an advertisement. The protagonist transfers this same logic to transplant surgery. Being physically damaged, he believes that his life would be more satisfying if he had a new hand. Loher observes this outlook and lifestyle with skepticism and casts doubt.
Though each play has its own cultural emphasis, both plays show the struggle between human values/beliefs and rapidly changing health technologies. As a possible answer, the German as well as the Japanese playwright show individuals who deeply regret having undertaken their medical (mis)adventure into the realm of transplant technology. Tada calls them “[p]itiful souls” (TWoI I) and points to the spiritual dilemma at hand. The violence of the procedure seems to preclude the possibility of a calm and smooth separation of body and mind and similarly a peaceful transition from life to death is presumably corrupted by hasty organ removal. Writing from an overtly secular background, Loher focuses instead on what transplantation does to the living: Man #2 seems morally exhausted by the consumer culture that promises a better life through endless gratifying pleasures of the self. Striving for physical perfection leaves him shallow and void. Leon Kass calls this the sad irony of biomedical projects: “We expend enormous energy and vast sums of money to preserve and prolong bodily life, but in the process our embodied life is stripped of its gravity and much of its dignity. This is, in a word, progress as tragedy” (1992: 85).
It holds true that the two works address organ transplantation from different angles, nonetheless they both deal with the concomitant ethical questions. The thought-provoking impulses that stem from Hände and The Well of Ignorance enrich public discussions on organ transplantation. Even more, Loher’s and Tada’s play on organ transplants can be potent and exciting instruments of knowledge.
[i]To date, there exists no official translation of the play into any other language. My analysis is therefore based on the unauthorized translation of a theater performance staged in Cleveland, USA. As to whether this translation, only five pages in length, does justice to the original Japanese is beyond my assessment. However, it can be assumed that the original is also relatively short, as Noh plays are usually dense in metaphorical allusions and non-verbal elements. Within the following analysis I will refer to the material provided by S. Kita and B. Parker (1994), which is divided into acts I and II.
[ii] The subsequent quotes from Hände have been translated into English.
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Sita Maria Kattanek has graduated at the University of Freiburg, Germany, with a degree in German literature, English Philology and Economics. Having been granted a scholarship by the DAAD and the Landesgraduiertenförderung Baden-Württemberg, she composed a PhD on representations of organ transplants in contemporary literature. Sita Maria Kattanek currently works for the German publisher Carl Hanser in Munich.