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Book Review: The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South by Chip Jones

Image of a digital book cover. A graveyard is in the background. The book title is laid over it in white, with three red stars, and then the author's name.

Summary:
In 1968, Bruce Tucker, a Black man, went into Virginia’s top research hospital, the Medical College of Virginia (now Virginia Commonwealth University) with a head injury, only to have his heart taken out of his body and put into the chest of a white businessman. Covering the inequalities innate in cadaver harvesting through the mismanagement of discovered human remains on university property in the 1990s, journalist Chip Jones explores how organ transplant in the US reveals systemic inequalities and racism, not just in health care, but in other related fields as well.

Review:
Organ transplant science is something that can feel like it’s been around forever, but in fact it’s really still a fairly new form of treatment. The first transplant of any organ was in 1954, and the first heart transplant was in 1967. The Civil Rights Act was in 1964, so at the time this treatment was emerging, segregated health care was still present in the US.

This book first gives context to the inequities seen in organ donation and reception by looking at the topic of where student doctors get cadavers to practice dissection upon. Although currently there is a system in place for the ethical donation of remains for educational use, at the time there was no such system in place. Medical schools turned to grave-robbing – and they preferentially robbed from Black graveyards. Black families called these “night doctors.”

Parents even used the specter of “night doctors” to make their children stay in bed. “You’d better go to sleep,” they’d say, “or the student doctors will get you.”

(loc 3353)

This was also a time period where there was some debate about what counts as death. Legally, until 1968, death was the full cessation of the working of all organs. In 1968, with advancing science, the theory of brain death was proposed. This was partially due to new health care technology that allowed for a machine to keep the organs operating. In tandem, the science of organ transplantation was emerging. The fresher the organ, the better the chances for the transplant to succeed. With the emerging theory of brain death meaning organs were operating but the patient might be able to be considered dead, and I’m sure you can see where this was going.

Bruce Tucker was a blue collar worker. He was hanging out with friends having a few drinks of alcohol on a stone wall. He fell and suffered head trauma. He was brought to the hospital alone. In spite of having his brother’s business card in his pocket, no one called his brother. Police officers were sent to his home to try to find family, but he didn’t live with his brother. At the same time, a white businessman was waiting for a heart transplant at the same hospital.

The early conversations among the surgeons had little to do about his chances for survival but rather concerned using him for another purpose. No one was discussing whether he might recover and be rehabilitated….Men like Tucker, arriving with alcohol on their breath and seemingly no one to claim them were often written off as ‘charity patients.’ They weren’t expected to pay their bills, with the hospital absorbing any expenses.

loc 2064

Jones notes that Tucker thus suffered from what can be termed a social death. Arriving at the hospital with alcohol on his breath meant that he was looked down upon by society, on top of how he was already perceived as a Black man in a Segregated southern hospital. Add to that the fact that the hospital decided he seemed to have no loved ones, and he was viewed as disposable.

Tucker did have loved ones, though, and when his body was sent to the funeral home, the caretaker notified his family that he arrived without a heart. This is when Tucker’s brother started to pursue answers and justice.

The next part of the book deals with the lawsuit that came about and how the court case was ruled. I wasn’t surprised, but was still severely disappointed to see how the hospital and doctors got away with it, and the Tucker family was left without justice. Notably to me is the quote from the prosecuting lawyer,

It doesn’t change the fact that when they took his heart from him he was not dead according to the law. So they broke the law and never would admit it, and that’s what bothered me more than anything else.

(loc 4397)

A clarifying note that the defense team used the argument of brain death, which was not the law at the time. The defense team also organized for as many transplant experts as possible to be in town at the time of the trial. They arranged for a transplant conference that just so happened to coincide with the scheduled trial. The conference was sponsored by Pfizer. The book notes just how much sway having transplant experts on the stand had on the judgment.

What stood out to me in reading this book is how societal inequalities and judgements can and do severely impact the quality of care that a patient might receive. I also was surprised to learn how recently brain death became the standard, and to read about the arguments on both sides of that debate. Brain death is not as clear-cut as I once thought it was.

The author does a good job of making history personal by focusing on Bruce Tucker and his family but also fleshing out with enough surrounding historical details that the complex situation made sense to read about. I do think his epilogue was unnecessary, where he details trying to speak with Bruce Tucker’s son, who did not want to speak to him. I feel that truly leaving Bruce Tucker’s son alone would have entailed simply a note that he did not wish to be interviewed and leaving it at that.

Overall, this is a fascinating and sad read about the history of organ transplants and brain death in the US. Recommended if these topics interest you.

4 out of 5 stars

Length: 400 pages – average but on the longer side

Source: NetGalley

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Book Review: To ‘Joy My Freedom: Southern Black Women’s Lives and Labors After the Civil War by Tera W. Hunter (The Real Help Reading Project)

January 14, 2012 9 comments

Mosaic-style art depicting three black women doing laundry.Summary:
Hunter examines the lives of southern black women, particularly southern domestic workers, by narrowing her focus in on the development of the city of Atlanta after the Civil War.  Since many ex-slaves moved to Atlanta and then migrated again north during the Great Migration decades later, this makes for an excellent focal point for the topic.  By examining black women’s lives in Atlanta both in and out of their employer’s homes, she is able to dissect the roles of race, class, and gender in the elite’s attempts to maintain dominance in America.

Review:
I’ve said throughout the project that the nonfiction books have come up a bit short for me.  Although they’ve contained valuable information, they haven’t been the most readable.  Nonfiction can tell a story too, and Hunter does exactly that.  She explores so much more than just the women’s lives in relation to their employers.  Atlanta truly comes to life as we see the women commute to work via bicycle so as to avoid racist trolley lines and kick up their heels on the interracial Decatur Street after dark.  We also get to see the empowering role of secret societies in black women’s lives, as well as reclamation of performing in black face and the terrifying resurgence of the Ku Klux Klan.  It is impossible not to be moved and outraged by the tale of these women’s struggles.  The book addresses three issues: classism, racism, and sexism.

In spite of Americans being told repeatedly that the American Dream is available to all if you work hard enough, Hunter quickly shows how the poor are fighting a losing battle and on top of it are demonized by the wealthy.  For instance, the use of debt to keep the poor enslaved:

Poor women often borrowed money in meager amounts, less than one dollar at a time, amassed running accounts for several months or years, and repaid ever-accumulating interest in small installments. Many moneylenders were usurious. It was common for borrowers to pay 250 to 3500 percent interest on small sums, which exacerbated poverty with interminable debt. Fannie Holman, a washerwoman, borrowed between $60 and $90 over a two- or three-year period. Though she would repay over $1,000, the creditor applied it to defray the interest but not the principal of the loan. (page 134)

Similarly, upper class employers’ attempts to control every aspect of their employee’s lives, claiming a right over their bodies:

Dance halls were a menace, declared Proctor, because “the servant class tried to work all day and dance all night.” He warned employers that household laborers would not perform well if they used their leisure unproductively—dancing instead of resting in preparation for the next day of work.  (page 179)

Hunter via maps and clear explanations demonstrates how the wealthy acquired the highest land in Atlanta most conveniently near shopping and such, while the poor and blacks were forced into the lowest land that, in addition, sewage was dumped into.  These conditions combined with the poor housing provided by slumlords made a perfect scenario for disease, and yet the poor were blamed for the outbreak of tuberculosis in the city and even accused of exposing wealthy whites to it:

  Tuberculosis signified more than a purely physiological condition. The disease became a medium for “framing” tensions in labor and race relations, with the rhetoric cloaked in scientific and medical legitimacy. (page 187)

Of course, the fact that black workers were poor was no coincidence.  The entire city conspired since the Civil War to make black Americans poor and keep them that way.  The wealthy whites, and in a lot of cases the poor whites, wanted black people out of sight and out of mind unless they were actively in service to them

Jim Crow and domestic labor thus represented contradictory desires among urban whites striving to distance themselves from an “inferior race,” but dependent on the very same people they despised to perform the most intimate labor in their homes. (page 105)

Segregation was not a system imposed entirely from above; it also helped to advance the interests of white workers, who were able to gain status from their position in the social hierarchy above all blacks. (page 119)

Jim Crow parks were designed not simply to put white urbanites closer to nature, but also to give them moments of reprieve and distance from blacks in order to channel racial friction in “wholesome” directions. (page 147)

Of course, on top of having their fight for the right over their own bodies and lives depicted by the ruling white class as them being uppity servants and uppity blacks, women had the additional injustice of having their femininity and womanhood called into question.

Like the defiant women in Galveston, strikers in Atlanta showed little attachment to prevailing middle-class conventions of femininity. As they did on other occasions, working-class women used street fights to settle disputes that jeopardized their unity and engaged in militant resistance. (page 89)

The moral implications of women consuming intoxicating substances troubled many middle-class blacks and whites. Women not only evaded laws prohibiting them from entering saloons, they frequented bar room “annexes,” they drank alcohol in alleys and streets, and they sold beer from their homes. (page 165)

I usually don’t quote this much, but the whole book is just so good.  The three-way injustices faced by black working class women is palpable throughout.  Facing one alone would be daunting enough, but facing three feels terrifyingly insurmountable even just reading about it, let alone living it.  And yet some black domestic workers did pull through in spite of the odds and do great things.  Women like Carrie Steele.

Former slave Carrie Steele, a stewardess and cook at the train station, volunteered her time as a probation officer for children in trouble with the law. This experience and her childhood as an orphan inspired her to start an orphanage in 1890. She believed that many of the children she came in contact with had fallen on hard times because they had no families to take care of them. Steele raised money to purchase four acres of land and the orphans’ first home by selling her own house, writing and selling her autobiography, and soliciting funds from generous individuals, black and white. By 1898 the Steele orphanage consisted of a brick building, hospital, and schoolhouse, and more than two hundred children had passed through its portals since its founding. (page 142)

Inspirational. Humbling. Awe-inspiring.  Words that describe both Carrie Steele’s life and the book as a whole. Read it.

Source: Public Library

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Discussion Questions:

  • Why do you think Decatur Street was allowed to continue in spite of being the only known location in Atlanta where the races mingled?
  • Hunter values the dance halls for the role of letting off steam and embracing black culture they played in black Americans’ lives.  How do you feel about them?
  • In spite of viewing black Americans as “unclean,” white Atlantans persisted in sending their laundry out to black homes to be washed.  Why do you think people were able to hold onto such illogical dichotomies?
  • Given the depiction of of everything stacked against them, do you view drug dealers, bootleggers, prostitutes, etc… differently now than you did before?
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