9 Gift-of-life? The Psychosocial Experiences ... 221for a heart will die if a donated organ does not become available in a
timely manner. As regards social worth, fewer hearts are available for
transplant and it is surgically more difficult to replace a heart (than a
kidney, for example). These factors lead to hearts having a higher social
value. However, it is perhaps in terms of symbolic weight that hearts
can be most differentiated from other organs for transplant. Hearts are
‘linked to selfhood by being traditionally considered as harboring the
feelings and character of the person, a cultural factum that is heavily
inscribed in human languages by powerful metaphors involving the
heart’ (Svenaeus 2012 : 78–79). Equated with life, love, passion and the
soul, it is often our hearts that are seen to define us as human, and alive
(Sharp 1995 ).
Organ scarcity is widely acknowledged as the dominant, and most
persistent, problem faced in contemporary transplantation (Jonsen
2012 ), and knowledge of the extent of organ scarcity serves to empha-
sise the magnitude of ‘the gift’ for those who are in receipt of it. The
social worth and symbolic weight of the heart is such that it magnifies,
even further, what is given and received in the context of heart trans-
plantation. As noted by Douglas ( 1992 : 162), visible gift exchanges are
‘readily subject to public scrutiny and judgments of fairness’. Through
their narratives, heart recipients revealed an acute awareness of this,
and many clearly felt the need to establish their worthiness of receiv-
ing a rare and precious heart (O’Brien et al. 2014 ). Some attempted to
establish that failure of their (original) heart occurred despite maintain-
ing a healthy lifestyle: that is, it was not the result of any wrongdoing
on their part. They spoke of engaging in good health practices such as
regular exercise, maintaining a healthy diet, and not smoking or con-
suming excessive amounts of alcohol. They distanced themselves from
blame through their accounts of unfortunate circumstances resulting in
major heart damage, and in highlighting their blamelessness, attempted
to demonstrate their deservingness of a heart transplant.
Age was also raised as an issue in relation to deservingness. Two of the
older men believed they had received the heart of a young person, and
they both struggled with concerns that the donor family might discover
the heart of their loved one had been given to an ‘old fart ... instead of
going to some young person that has got his life ahead of him’ (Colin)
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