Industrialist Harsh Goenka recently tweeted a photograph of a young woman and her father baring their midriffs to reveal a large red scar resembling an inverted L. The woman had donated her liver to her father and the two had posed for a picture after the surgery. The April 18 tweet went viral, for it was an extraordinary photograph that took most people by surprise. Women do not usually display scars on their bodies, possibly because it diminishes marriage prospects. But what was more striking was the mention of organ transplant, a topic that is seemingly everywhere all of a sudden.
If you take a longish taxi ride in Mumbai, you’ll notice three types of billboards — selling real estate, web TV shows and organ transplants. The first two are commonplace enough, but transplants? One hospital claimed in its ad that it was so good at transplants that it was giving itself one. Another said it had 10 years of experience in transplants, while a third tom-tommed its count of heart transplants. Not just on billboards, the ads pop up even on the internet. In the middle of scrolling through Facebook, sandwiched between “tips for abs in 10 days” and “seven quick egg recipes for breakfast”, is a post soliciting donations for an organ transplant to save a child.
There have been kidney transplants in India since the 1970s, but other more complex transplants — such as liver and heart — have achieved a decent rate of success from the mid-2000s. According to the National Organ & Tissue Transplant Organisation, the number of kidney transplants nearly trebled to 4,805 in 2018, from 1,684 in 2017, while there was a 160 per cent jump in the number of liver transplants — from 708 in 2017 to 1,130 in 2018.
One clear indicator that organ transplant has arrived, so to speak, is its entry as a plot point in several recent Hindi films. Some of these films, such as
The incredible generosity involved in the gift of an organ to another person makes for compelling stories, of course. That’s one reason. But the Hindi film also has a keen sense of market forces, largely what the affluent can afford. Just as you see a lot of photographers and chefs as Hindi film protagonists and plots that involve extensive European locations, there are plot points involving organ transplants. Transplant surgeries are among the most expensive medical procedures in general — a liver or heart transplant costs ₹15-20 lakh. Even a kidney transplant (₹3-7 lakh), now considered routine, is more expensive than a knee replacement surgery (₹2-3.5 lakh), which is fairly common among the mostly sedentary class of affluent Indians. Yet, how often has a knee replacement featured in Hindi films? Do you ever remember a gall bladder removal — among the commonest surgeries — mentioned in a Hindi film?
Blood in the veins
What’s interesting is that the transplant always involves a criminal dimension in these films — organ sales, organ theft, murder or intent to murder. On the other hand, blood transfusion always has a positive association, bringing people together, as the American anthropologist Lawrence Cohen pointed out in a 2001 book. In Sujata (1959), the low-caste heroine played by Nutan saves her high-caste adoptive mother by giving her blood. In Amar Akbar Anthony (1977), the three brothers donate blood to the mother, setting off a chain of events that brings the family together. In both films, blood is a metaphor for the modern Indian nation — the tie that binds everyone together is not caste or faith, but citizenship, which is as intrinsic as the blood that courses through people’s veins.
In Sultan (2016), a blood donation camp organised by Anushka Sharma’s character is the start of her relationship with Salman Khan’s title character. Later in the film, the dream for a blood donation centre that stocks rare negative blood groups brings the estranged couple back together, and helps the hero clean up his life. Even in Kahaani (2012), blood donation and blood banking help locate an assassin. Blood donation works for the national good — a terrorist is identified and killed.
Consider the transplant, on the other hand. The most amoral character in Andhadhun is a doctor who steals organs for transplantation. The doctor informs the hero, played by Ayushmann Khurrana, that he didn’t extract his kidneys because Khurrana had saved him from death. He also harvests the heroine’s liver for a sheikh who promises him $5 billion.
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Ship of Theseus is a triage of stories braided around organ transplantation. Two of the stories show the life-changing gift that an organ can be: A photographer gains sight, and a monk full of fortitude and conviction wastes away to near-death before receiving a liver transplant.
Yet the third story is about an organ selling racket — a kind-looking man in Sweden gets a kidney transplant in India and a stick-thin man in Mumbai, bent crooked, discovers he has a scar to the left of his abdomen. Even a film that is about the lifesaving power of organ donation is incomplete without a reference to the widespread menace of organ trade across the world.
In Saheb (1985), hero Anil Kapoor decides to sell his kidney to get his sister married. Selling a kidney, however heroic a sacrifice, is itself a criminal act. The Transplant of Human Organs Act, which permitted living organ donation only expressly for non-commercial reasons, was passed in 1994. Still, the buying and selling of organs was never legal activity in India. There may have been no law prohibiting it, but there was no law permitting it either.
Even in a film such as Traffic (2016), celebrating the orchestral coordination required to facilitate a successful transplant, the transplant surgeon himself is planning his wife’s murder. Everyone else in the ambulance — the constable driving, the senior cop coordinating the quickest route for the retrieved heart — is focused on saving a life. In the web series Breathe , which premièred last year, the anxiety of waiting for a lung transplant for his son drives R Madhavan to murder all prospective donors with the matching AB- blood group.
In their widely cited works, anthropologists Nancy Scheper-Hughes and Veena Das have (separately) noted how the success and spread of transplant technology have in its wake created the notion of a global scarcity of organs (and tissue). This purported scarcity has created black markets in organ trade in several parts of the world, with India and the Philippines being nodal points. American Scheper-Hughes and Das, who taught in Delhi University, primarily blame transplant doctors for this cannibalistic market. Their qualification and expertise make it difficult for patient families to question whether a transplant is really required. It is unclear whether Hindi filmmakers read medical anthropology but they hold the same disturbing view of the transplant industry.
On May 27, 2012, in the fourth episode of his show Satyamev Jayate , Aamir Khan featured the case of a woman who died after a transplant surgery by an unnamed nephrologist. The woman’s husband alleged that she was suffering from renal failure, and a pancreas was transplanted needlessly along with the required kidney transplant. This caused her death. The show received pushback from doctors’ bodies, and the unnamed doctor effectively outed himself by complaining publicly against Khan and his show. Not entirely coincidentally, perhaps, Ship of Theseus , released the year after, was produced by Aamir Khan’s company.
Adventures of plastic surgery and IVF
Other sophisticated new medical technologies have invoked happy impressions, even if they involve behaviour that is arguably illegal. Annu Kapoor is an affable IVF specialist in Vicky Donor (2012). But what he does in his practice — selling one man’s sperm to all his patients — cannot be legal. In Khoon Bhari Maang (1988), a plastic surgeon gives a fabulous makeover to a woman who was mauled by a crocodile and enables her to take revenge on the man who had pushed her into the jaws of the reptile. The avenging woman, played by Rekha, commits a series of extrajudicial attacks with her surgically-enhanced confidence.
The sophisticated trauma care given to Banita Sandhu’s character after she slips and falls from a building in October (2018) is exorbitant but impressive. The young woman called Shiuli regains consciousness after a prolonged coma and progresses to basic motor skills such as moving her eyeballs. The neurologist who leads her treatment speaks of the consciousness of the soul that exists beyond what science can know. In a film that is set, for the most part, in the anxious white light of intensive care, he is like a fairy godfather speaking of rainbows amid ceaselessly beeping machines. It is the doctor who seems to shift something in the hero Dan and bring his restlessness to an end.
But this is a small role, and an exception really. The doctor as a hero has receded from the Hindi film, particularly after Munnabhai MBBS . Thereafter, doctors have almost always appeared as negative characters, despite the enduring success of English-language medical shows such as House MD and Grey’s Anatomy . A new film called Kabir Singh stars Shahid Kapur as a brilliant, university-topping surgeon, who snorts coke and drinks straight from the bottle. His exam results notwithstanding, this is exactly the sort of portrayal that leads to doctors being beaten up in real-life situations.
The arc of the Hindi film doctor is perhaps best seen in Amitabh Bachchan’s filmography. In Anand , as Dr Bhaskor Banerjee, he is already bored of his wealthy patients complaining of imaginary diseases and spends his evenings writing and drinking. As Bhaskor Banerjee in Piku , he is a hypochondriac himself and his confidante is a homeopath. In a way, this is a reflection of what medicine is today. As medical technology becomes more sophisticated, and healthcare more expensive, the doctor seems less central, and certainly less heroic. Yet medical technologies and their possibilities make for fascinating, even if frightening, stories.
Also read:Where have all the characters gone?
Sohini C is a journalist and writer