Transplanting Care: Shifting Commitments in Health and Care in the United States

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.