The Birth of Morbopolitics: Pittsburgh and the Normalization of Organ Transfer

Kimberly Klinger

Advisor: Roger N Lancaster, PhD, Cultural Studies Program

Committee Members: Denise Albanese, Craig Willse

Enterprise Hall, #318
April 26, 2016, 01:30 PM to 10:30 AM


This dissertation conducts an inquiry into a time and place that I see as the key to understanding the emergence of the modern era of organ transplantation: Pittsburgh’s University hospitals (UPMC) in the 1980s and 90s. During these years, the hospital’s once modest program grew to become the largest, busiest, “most messianic,” and most successful transplant center in the United States. This was largely due to the arrival in 1981 of Dr. Thomas Starzl, a pioneer in the field, who brought with him new techniques for liver transplantation as well as novel immunosuppressant therapies. The “Starzl years” ushered in a new era in medicine: one in which organ transplants went from being considered untenable to one in which they became not only standard medical practice but an imperative treatment, both nationally and across the globe. My project seeks to understand how events at UPMC facilitated this sea change, providing a case study of the clinical medical practices and policies at the epicenter of these transformations.  It examines three key tensions surrounding the lives and deaths of patients through which the development of the transplant industry played out: the wavering and contestable boundary between experimentation and therapy; the competing but often overlapping interests of medicine and politics (and in particular, the influence of the Pittsburgh program on national policies); and the redefinition of death and the contingent extension of the lives of the chronically ill. A series of new practices and concepts took hold, which, I argue, both normalized organ transplantation and suspended desperately ill patients in what I call a “morbopolitical” regime: a zone of exception between health and death, where patients are held under perpetual treatment. The morbopolitics of organ transplantation ultimately requires that patients ignore the distinctive qualities of the practice – its reliance upon a still-controversial definition of death, a conceptual dissolution of the boundaries of the body, and the necessity of lifelong immunotherapy and surveillance – in order to extend their lives, at any and all costs.