Blood & Guts – A History of Surgery: Spare Parts is the third part of the BBC Four documentary series about the “brutal, bloody and dangerous history of surgery” focusing on the development of transplant surgery. The documentary primarily gives a graphic account of the history of transplant surgery, in particular focusing on the work of Alexis Carrel (00:04:24 – 00:22:47), Joseph E. Murray (00:22:47 – 00:45:32) and Sir Roy Calne (00:36:40 – 00:45:32). However both at the beginning (Start – 00:04:24) and the end of the programme (00:45:32 – End) Michael Mosley (Also seen in BBC’s documentary series Medical Mavericks) discusses some of the ethical concerns that may arise from transplant surgery. Mosley meets with two patients who have both had a hand transplant, however only one of the patients is able to keep his new hand as it illustrates the success and failure of the radical surgery.
This episode is a bit of a bioethics-fest! In addition to the xenotransplantation storyline started in the previous episode, there is also a discussion of the clinical use of stem cells, and some ethics of whether or not to honour a “do not resuscitate” order thrown in for good measure. Several sections could prove useful for introducing xenotransplantation (6:30 to 7:40; 10:06 to 11:00; 29:14 to 30:28). I think that the clip from 10 minutes into the episode is the most valuable discussion start; in a conversation between Abra and Mickie several of the main safety concerns are clearly expressed. For more on the science and ethics of this procedure, see a Bioethics Briefing on Xenotransplantation that I wrote a couple of years ago.
Regarding stem cells, the best clip is from 22:13 to 23:30. In this section, Gina (who is suffering from Motor Neuron Disease) discusses with her doctor whether or not she should fly to Singapore for injections of stem cells. This is the sort of procedure that was also being discussed in Susan Watt’s excellent Newsnight investigation into experimental stem cell therapies (a streamed video can be reached from this link).
A recent episode of the medical drama Holby City has a 90 second clip that could prove a very nice introduction to the concept of xenotransplantation. In the episode “Better the devil you know“, first broadcast on September 6th 2006 (Sept 7th in Scotland), a terminally ill man has to come to terms with the fact that he can no longer receive the kidney transplant he had been expecting. Just at the end of the episode (starting 54 and a half minutes in), Dr Percival Durant (known as Abra, and played by Adrian Edmondson) tells the patient that he may be able to offer him a new solution and proceeds to give a very useable explanation of xenografts. This could lead easily into a discussion of the scientific and ethical problems with a transplant of this type. For those with access to the services of BUFVC, the TRILT identifier for the episode is 005BDB24. The actual operation takes place in the next episode “Star maker“ (September 12th/13th).
Pig-Heart Boy is the fictional account of Cameron, a thirteen year old boy who takes part in a pioneering operation to receive a pig’s heart. An excellent and thought provoking story by Malorie Blackman (Corgi Books, ISBN 0552551663), it was also made into a TV serial in the UK. As you might guess from the age of the principal character, this resource works best for secondary rather than university students. This is particularly true for the TV version. There are, however, several short sections of the book that could be read out as a scene-setter for any age group. I particularly like the three and a half page section from the start of Chapter 3, where Cameron overhears his parents arguing about the operation (the first he knows about it) to the point where he storms upstairs and declares to himself “How dare they? It was my body. My heart”.
The equivalent section occurs in episode 1 of the TV version (‘The D word’). The text is altered somewhat, but has the advantage that it cuts straight into the family going to visit Professor Rae, the xenotransplantation expert. Hence the 5 minute clip from 14:30 to 19:14 would make a very useful and thought-provoking intro to the topic.