Transplanting Care

Shifting Commitments in Health and Care in the United States

By Laura L. Heinemann

SERIES: Critical Issues in Health and Medicine

Rutgers University Press

The sudden call, the race to the hospital, the high-stakes operation—the drama of transplant surgery is well known. But what happens before and after the surgery? In Transplanting Care, Laura L. Heinemann examines the daily lives of midwestern organ transplant patients and those who care for them, from pretransplant preparations through to the long posttransplant recovery.

Heinemann points out that as efforts to control healthcare costs gain urgency—and as new surgical techniques, drug therapies, and home medical equipment advance—most of the transplant process now takes place at home, among kin. Indeed, the transplant system effectively depends on unpaid care labor, typically provided by spouses, parents, siblings, and others. Drawing on scores of interviews with patients, relatives, and healthcare professionals, Heinemann follows a variety of patients and loved ones as they undertake this uncertain and strenuous “transplant journey.” She also shows how these home-based caregiving efforts take place within the larger economic and political context of a paucity of resources for patients and caregivers, who ultimately must surmount numerous obstacles. The author concludes that the many snags encountered by transplant patients and loved ones make a clear case for more comprehensive health and social policy that treats care as a necessarily shared public responsibility.

An illuminating look at the long transplant journey, Transplanting Care also offers broader insight into how we handle infirmity in America—and how we might do a better job of doing so.

Succinct, convincing, and organized, Transplanting Care provides a thoughtful, ethnographically rich account of the day-to-day care involved in looking after transplant recipients before, during, and after their transplant surgeries. Lesley A. Sharp, Ann Whitney Olin Professor of Anthropology, Barnard College

With its clear and compassionate prose, Transplanting Care makes an important contribution to ethnographic insights into understandings of care, kinship, chronic illness, and the moral influences they exert upon everyday life. Somatosphere

Succinct, convincing, and organized, Transplanting Care provides a thoughtful, ethnographically rich account of the day-to-day care involved in looking after transplant recipients before, during, and after their transplant surgeries. Lesley A. Sharp, Ann Whitney Olin Professor of Anthropology, Barnard College

With its clear and compassionate prose, Transplanting Care makes an important contribution to ethnographic insights into understandings of care, kinship, chronic illness, and the moral influences they exert upon everyday life. Somatosphere

LAURA L. HEINEMANN is an associate professor of medical anthropology at Creighton University in Omaha, Nebraska.

Preface

Acknowledgments

Prologue

Introduction

1 Early Navigations

2 Troubled Relations and Former Lives

3 Precarity and Policy

4 When Patients Are Also Caregivers

5 Conscripting Caregivers’ Health (Or, When Caregivers are Patients, Too)

6 Transformations in Home Life and High-Tech Health Care

7 Revealing and Reframing Kinship and Care