Beyond the Bungled Transplant: Jesica Santillan and High-Tech Medicine in Cultural Perspective

Conference: June 11-12, 2004 Rutgers, State University of New Jersey (New Brunswick) Organizers: Keith Wailoo, Julie Livingston, Peter Guarnaccia

This conference brings together scholars from anthropology, history, health policy, ethnic studies, ethics, medicine, and sociology to discuss the global, local, and cultural meanings and significance of the death of the undocumented immigrant Jesica Santillan in 2003.

The tragedy, though caused by her “botched” organ transplantation, provides an important window on a variety of issues (to suggest only a few): 1) high tech medicine’s role in shaping a cross cultural commerce in organs, and the implications of the distribution of these new commodities, 2) the case’s exposure of cultural, politics, and economic assumptions about the workings of the health care system, 3) recent immigration in America, and the responses of society and the health care system to the needs of new populations, 4) the role of “third world patients” as subjects in the development of high-risk medical procedures, 5) the ideals and the realities represented by early 21st century American life and medical consumerism, 6) media coverage and medical spectacle, and 7) attitudes about the “rights” of Latino/a immigrants (documented and undocumented) with regard to health care and other services.

The conference focuses on intensive panel discussions of short pre-circulated papers. Conference organizers seek 1-2 page proposals (deadline, January 30th) for papers that use the Santillan controversy as an opportunity for broader, cross-disciplinary discussion and reflection. Expenses of the participants will be paid, and an honorarium will be provided. Interested participants are asked to submit their paper proposals to Professor Keith Wailoo at ([email protected] <mailto:[email protected]> ). We expect that an edited volume will be published from the proceedings.

Background. In February 2003, a 17-year old woman, became the center of national media attention when she became the victim of a dramatic medical mistake. After spending years ailing with a severe cardiac disorder and waiting on a heart and lung transplant registry, Jesica Santillan, a Mexican national living as an undocumented immigrant with her parents in North Carolina, received a transplant. But no one caught a crucial error. The organs had come from a donor with a blood type that did not match Jesica’s. The postoperative results were tragic. The organs were rejected by Jesica’s body. The story (as it played out at the Duke University Medical Center and in the American media) seemed to exemplify the best hopes and the worst features, the extraordinary promise and huge pitfalls, and (for some) the skewed priorities of the American health care system. Her mother’s health insurance covered much of the cost of the transplant while a sympathetic employer had helped to pay the rest. Through the following months, media coverage suggested that this was the story of a shattered immigrant family’s dream. Attention focused on who “bungled” and “botched” the case, on the wisdom of trying to save Jesica’s life by bumping her to the top of the waiting list for a second transplant, and on her decline and eventual death. Some complained that an “illegal” immigrant should never have been on the list, and many of the key actors – from Duke University and transplant specialists to the Santillan family – have since sought to learn lessons from the tragedy. The Santillan’s had come to America precisely to obtain this type of health intervention for their daughter, but this was not the expected outcome.