216 G. O’Brien
compromised sense of personhood (Kierans 2011 ). As Crowley-Matoka
( 2005 ) emphasises, life does not return to “normal” for organ recipients;
at least not the pre-illness state of normal many believe to be the prom-
ise of the ‘gift-of-life’. Instead, they may live in persistent liminality,
where they are caught ‘betwixt and between’ the roles of healthy/inde-
pendent/normal person, and those of ill/dependent patient. In short,
there is a chasm between the biomedical perspective of organ trans-
plantation as a bounded event and the lived reality for many transplant
recipients, which is an ongoing process of negotiating, and re-negotiat-
ing, normality.
In the quote above Francisco Varela (1946–2001), Chilean biologist,
philosopher and neuroscientist, reflects on his personal experience of
receiving a liver transplant. In doing so, he emphasises the gulf between
modern medicine’s capacity to act on and repair the human body via
sophisticated biotechnologies, and an understanding of how such tech-
nologies are subsequently enacted as lived-bodies. As Varela ( 2001 : 261)
peers inside himself at ‘the other’s liver’ and contemplates what has tran-
spired, he suggests that his situation can be considered in terms of sen-
timental extremes: as ‘being touched by ‘a gift’ (from somewhere, from
‘life’ or ‘god’), or else the simplicity of the doctors who remain set at
the level of their technical prowess’, with the lived phenomenon lying
somewhere between these extremes. His reference to ‘the other’s liver’ as
‘a gift’ (at one end of the spectrum of sentimental extremes) reflects the
broadly held understanding of donated organs, within both the medi-
cal and public spheres, as the gift-of-life. His assertion that organ trans-
plantation could also be considered no more than a demonstration of
current medical knowledge and surgical technique (at the opposite end
of the spectrum) is not one that is encouraged within the realm of trans-
plantation.
Gift-of-life
Gift-of-life is the sanctioned metaphor of organ donation (Fox and
Swazey 2002 ). In Mauss’s ( 1970 ) understanding of gift exchange theory
(GET), which is routinely utilised as a framework for conceptualising