A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship

A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship

A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship

A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship

Synopsis

In February 2003, an undocumented immigrant teen from Mexico lay dying in a prominent American hospital due to a stunning medical oversight--she had received a heart-lung transplantation of the wrong blood type. In the following weeks, Jesica Santillan's tragedy became a portal into the complexities of American medicine, prompting contentious debate about new patterns and old problems in immigration, the hidden epidemic of medical error, the lines separating transplant "haves" from "have-nots," the right to sue, and the challenges posed by "foreigners" crossing borders for medical care.

This volume draws together experts in history, sociology, medical ethics, communication and immigration studies, transplant surgery, anthropology, and health law to understand the dramatic events, the major players, and the core issues at stake. Contributors view the Santillan story as a morality tale: about the conflicting values underpinning American health care; about the politics of transplant medicine; about how a nation debates deservedness, justice, and second chances; and about the global dilemmas of medical tourism and citizenship.

Contributors:

Charles Bosk, University of Pennsylvania

Leo R. Chavez, University of California, Irvine

Richard Cook, University of Chicago

Thomas Diflo, New York University Medical Center

Jason Eberl, Indiana University-Purdue University Indianapolis

Jed Adam Gross, Yale University

Jacklyn Habib, American Association of Retired Persons

Tyler R. Harrison, Purdue University

Beatrix Hoffman, Northern Illinois University

Nancy M. P. King, University of North Carolina at Chapel Hill

Barron Lerner, Columbia University Mailman School of Public Health

Susan E. Lederer, Yale University

Julie Livingston, Rutgers University

Eric M. Meslin, Indiana University School of Medicine and Indiana University-Purdue University Indianapolis

Susan E. Morgan, Purdue University

Nancy Scheper-Hughes, University of California, Berkeley

Rosamond Rhodes, Mount Sinai School of Medicine and The Graduate Center, City University of New York

Carolyn Rouse, Princeton University

Karen Salmon, New England School of Law

Lesley Sharp, Barnard and Columbia University Mailman School of Public Health

Lisa Volk Chewning, Rutgers University

Keith Wailoo, Rutgers University

Excerpt

Keith wailoo, julie livingston, and peter guarnaccia

In February 2003 Jesica Santillan, a seventeen-year-old Mexican immigrant living illegally in the United States, lay unconscious in a room at the Duke University Medical Center in Durham, North Carolina. She was dying because of a stunning medical oversight. As the hospital spokesman explained publicly, Jesica’s surgical team had made a simple but tragic mistake in the hours leading up to her heart and lung transplant operation. Soon after replacing Jesica’s failing heart and lungs with healthy ones, the team discovered that the transplanted heart and lungs had come from a patient of a different blood type. the donor organs were type A; Jesica was blood type O. As this frail young woman’s immune system slowly rejected the organs and as doctors scrambled both to keep her alive and to find another set of compatible organs, her story attracted international media notoriety as the “bungled transplant.” For the next few weeks, the case became front-page news. But as more and more details of the Santillan story emerged, the meanings of the story compounded and reverberated in remarkable ways, gradually becoming a story about medical error, immigration, and alleged medical tourism. the organ transplant story also made for a toxic collision between a wider world of human commitments, cultural values, and political ideals.

Observers drawn from a wide spectrum of vantage points would come to characterize these events not only as an unfortunate personal tragedy for Jesica and her family but also as a prism through which profound problems in health care and American society came into focus. For some, the Santillan story was about illegal immigration and about foreigners taking resources that would otherwise have gone to American citizens. For other commentators, it highlighted an ongoing crisis of widespread error in medicine. the American media, cultural commentators, and politicians alike seized upon the Santillan story—for at the time (and still today) the story collapsed a range of pressing issues into one tragic narrative—questions about the promise and problems of high-technology (i.e., transplant) medicine, about the privileges . . .

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