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Nancy Scheper-Hughes

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Take a Deep Breath (Inhale): Organ Panics

Posted: 10/15/10 01:17 PM ET

Transplant medicine is what some of its strongest proponents, transplant surgeons, call a 'victim of its own success'. Anyone who is mortally sick with organ failure -- whether the heart, lungs, liver, or kidneys -- will grasp at anything for a second chance at life. The promise held out to those on the official organ waiting list is the 'gift' of a 'fresh', healthy, undamaged organ.

The problem is that as I write this piece, 108,947 Americans are stranded on the UNOS wait list. The odds of getting a legal, 'clean' organ are slim. In the first half of 2010 there were only 14,141 transplants provided through the gift of living related or deceased donor organs. Something is a bit batty here. The data are skewed by the US system that allows just about anyone -- even those who are so desperately ill the chance of surviving a transplant is almost nil and people over 80 years old -- to be listed on the official organ list.

Unlike Central Europe where 'presumed consent' operates (that is, you are a donor unless you say that you are not a donor at brain death), or in the UK where both organs and waiting lists are carefully rationed and rationalized by the National Health Service, or in Norway where giving a kidney or one lung or half a liver is considered not too much to ask a loved one to provide, we in the United States have allowed our official waiting list to run riot. The result is that some sick grandparents are now being coaxed to ask their 18-year-old grandchildren to fork up a spare kidney so that the grandma can live to see her great-grandchildren, presumably.

Organ scarcities, real or exaggerated, produce real organ panics, as those who are low-listed for an official UNOS organ try to solve their problem by illegal and sometimes criminal means, including traveling to a country in the third world to buy an organ through transplant brokers, some of whom, in real life, are surgeons.

In the United States illegal transplants take place in famous hospitals catering to wealthy foreigners from the Middle East who are able to pay cash and leave generous gifts to build new transplant units named after the cash donors rather than the poor blokes who were, in some cases, forced to donate one of their organs to the man who employed them as debt-peons. Americans who are not as rich as members of the royal family of Qatar, travel to more humble transplant units in South America, China, the Philippines, and Mexico, where they can obtain organs from people on death row (China) or from hapless patients in ICUs (Medellín) or by deals cut with illiterate peasants or silent Indian (Peru and Ecuador). In Columbia, Mexico, and Brazil, in some barrios and favelas controlled by gangs and death squads, drugs, guns and organs are trafficked.

A few weeks ago I flew to Riverside, California to interview a young woman I'll call Adriana, who was born in the tow of San Luis Río Colorado in Mexico. She was looking for help in getting the attention of local FBI agents to interrupt a gang involved in organs trafficking. Adriana, a solid woman in her late thirties, not a bit crazy, told of being trafficked and held captive by her ex-boyfriend, first as a sex slave and then as prostitute to his gang in Ensenada. Finally, she was (she said) coerced into kidnapping a small child from a poor day care center to be used as an organs donor for foreign patients. The boy, she says, was murdered in a large rural estate, near the US border, a ranch house equipped with an operating room.

Surgeons arrived to harvest and remove the organs packed in special fluid in plastic bags and carried off in Styrofoam containers. Was Adriana's story true or a nightmare produced by years of sexual abuse? The scars left by an ice pick on her back and round scars of human bite marks on her arm gave testimony to her physical abuse. But with only her word and no independent evidence, the existence of drug trafficking gangs involved in cross-border organ trafficking remains unverified, perhaps unverifiable.

Inhale a social thriller directed by Baltasar Kormakur (a 26 Films production in association with Blueeyes) to be released on October 22nd by IFC Films at the IFC Center in NY and Laemmle's Sunset 5 in Los Angeles and available on Video-On-Demand, throws the movie-goer into something resembling the nightmare world described by Adriana Gonzales. Paul (Dermot Mulroney) a haunted and uptight District Attorney from a spectacularly beautiful, affluent suburb of Santa Fe, and his emotionally fragile wife, Diane (Diane Kruger) are desperately searching for a deceased lung donor for their eleven-year-old daughter, Chloe, dying of a rare disorder for which there is no cure. A senseless traffic accident provides a brain dead child who is a near perfect match for Chloe, but UNOS has designated the lungs to another patient on the waiting list.

Paul, egged on by his increasingly unstable wife, gets access to privileged information, (HIPPA not withstanding) about illegal transplant tours in Juarez Mexico through Harrison (Sam Shepard), a feisty old son of a bitch running for office as Governor of New Mexico. Paul outs Harrison about the politician's illicit trip to a Mexican clinic in Juarez where he was transplanted with a heart of uncertain origin by a certain "Doctor Navarro". Inhale follows Paul into the dregs of drug and sex trafficking dens in the Baja borderlands where all things are possible to those who are tough enough, desperate enough, or rich enough to define a new asocial world in which saving one's own life, or the life of one's child, is seen by those convulsed with power, greed, grief, fear, or rage as the only thing that really matters. Despite some head-splitting and gratuitous violence the film weaves together the strands of a nail-biting horror story into a complex emotional tapestry in which suspense, violence, brutality and the gritty street life of the underside of Juarez are relieved by the gorgeous sunrises of Santa Fe and a few strong rays of human compassion across both sides of the border. You can watch the Inhale trailer below.