My dear friend Charlie died by suicide when he was just 18 years old. He was not the first person I knew who died young, or the first person to leave my life through that particular door. However, he was the first person I knew who died in the prime of his physical existence and thus represented a cornucopia of rich and strange gifts to the organ donors list.
I’ve been marking yes on the organ donation button since my very first driver’s license, believing that someone might benefit from my death and liking that idea very much. I’m not a smoker; take the lungs while they’re still pink. Everyone has thought of the heart in a cooler being delivered by helicopter to a person on the brink who needs help pumping blood and maybe will inherit my emotional connection to Star Trek. Poetic souls have made much of cornea and iris transplant; what is it to see through the eyes of someone else, incorporating the gift of vision from the dead. These aren’t simple operations; they represent highly sophisticated science that must be executed by skilled surgeons and technicians who train for this specialty in medicine. But it’s become normal to us. It’s part of the world we know: some people who need a liver or a kidney will get lucky enough for a living or nonliving donor to give them one.
But Charlie’s death taught me that there are more parts to it than we typically think about, or that even show up on television shows about this visceral drama. For example, most people don’t know that bones can be donated. Cadaver bone can be used in grafts and in surgeries to lengthen the bones of a person’s arms or legs. Skin can also be harvested from a recently deceased person and donated to burn victims for grafting. The idea of a grafted tattoo is compelling to the writer of this article, but there are requirements in all things: donated skin must be free of tattoos, scars, and stretch marks.
Quiet, patient people came for pieces of Charlie I didn’t know could be of use. Cerebrospinal fluid can be recovered from a body for testing and research that could benefit folks suffering from neurological diseases. Researchers in this field can also use brain tissue, pituitary glands, and the spinal cord itself. Blood, too, can be harvested for research, although scientists in Russia in the early 20th century experimented with cadaveric blood transfusions to the living, as well.
Nor are reproductive organs exempt from this fascinating process. Uterine transplants have been tried over the last few years, with a successful live birth arising from some lucky recipients. Penile and scrotal transplants have been tried out on people recovering from combat-related injuries, restoring urinary and sexual function. However, transplanting ovaries or testicles raises a complication: gametes produced by the donor body will carry the donor’s DNA. The recipient of the transplant, if able to produce offspring, would be as unrelated to that child as a surrogate or a step. Legally and perhaps spiritually, we’re not sure what to do with that yet.
Faces, our most significant identifying feature and arguably our most personal possession, can be donated by a cadaver and transplanted to a new person’s body. This series of complex operations can be indicated after major trauma to the face, or to replace a genetically compromised facial structure. Whatever the reason, this process is incredibly delicate, involving thousands of minute nerves and rich blood supply. Think of all the things a face can do, every little twitch and quirk, every function of speaking and eating and kissing and spitting. Multiple surgical teams must coordinate to make this happen, but there are documented successes of swapping one face for another.
Even hands, those clever servants of the mind whose oppositional dexterity makes us different from all other apes and lets us play sonatas and stamp ravioli can be transplanted from one person to another. Following disfigurement through industrial accident or amputation, some people have been able to regain manual control of their lives through cadaver donation. Like facial transplant, this is an incredibly difficult process, involving multiple surgeries and not typically included on the list of acceptable donated tissues when someone just marks yes on a form at the DMV. The consent of the grieving family must be obtained to remove the hands from a body and attempt this wondrous act. But where that decision can be made, a virtual miracle can be wrought.
They came for Charlie’s hands. They came for his eyes and skin, his spinal fluid and his bones. I remember when it happened I kept thinking about whalefall. When a massive whale dies and falls to the seafloor, it breaks down and nourishes the life around it. Scavengers eat what they can, making their homes in the richness of the leviathan’s wake. Coral and limpet attach to the skeleton and grow strong off the free calcium. Charlie and the whale and of course, thinking about myself. I imagined dying one day, maybe biting the dust on my walk home, and thinking how much better it would be if I could signal to the people around me: take these groceries I just bought. Empty my wallet and take my boots—they’ve still got plenty of tread. Shave my head and make a wig for a drag queen. I said yes and I meant it; take everything from me that someone else might still use. Charlie said give it away now, and to my dying breath, I agree.
