title: Guardians of 'the gift': the emotional challenges of heart and lung transplant professionals in Denmark.
abstract: This paper deals with the emotional challenges encountered by doctors and nurses caring for heart and lung transplant patients. Organ transplantation enables body parts from the dead to become usable in patients with no other life-saving option. These exchanges are not possible without transplant professionals carefully selecting, guiding and interacting with organ recipients before, during and after the transplant. Based on anthropological fieldwork at a Danish heart and lung transplant unit, the paper explores how doctors and nurses experience and handle the emotional challenges of their working life. By focusing on the everyday life of the transplant unit which, contrary to public understanding of transplant miracles, is sometimes characterised by sad cases and devastation, this paper argues that transplant professionals operate in the presence of death. Medically and emotionally they are at risk. They must take the difficult decisions of whether to admit critically ill patients onto the organ waiting list; face the distress of post-transplant sufferings and deaths; and deal with organ recipients who do not behave according to post-transplant recommendations. Drawing on a familiar metaphor for donated organs, it is suggested that transplant doctors and nurses are 'guardians of the gift'. Attention to the emotional burdens and rewards of this particular position enables new understandings of the practices of transplant medicine, of gift exchange theory, and of the role of emotion in medical practice.
authors.affiliation: a Centre for Medical Science and Technology Studies, Department of Public Health , University of Copenhagen , Oster Farimagsgade 5A 1014, Copenhagen , Denmark.
authors.forename: Anja M B
authors.initials: AM
authors.lastname: Jensen
mesh_terms: D060432:Anthropology, Medical; D001291:Attitude of Health Personnel / Q000208:ethnology; D001293:Attitude to Death / Q000208:ethnology; D000066491:Clinical Decision-Making; D003718:Denmark; D004644:Emotions; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D009726:Nurses / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D009927:Tissue and Organ Procurement
keywords: Denmark; Organ transplantation; emotional work; gift exchange; transplant professionals