Flesh yours, Bones Mine The Making of the Biomedical Subject in Turkey by Aslihan Sanal SUBMITTED TO THE PROGRAM IN SCIENCE, TECHNOLOGY AND SOCIETY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THeEDEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT OF HISTORY, ANTHROPOLOGY, SCIENCE, TECHNOLOGY AND SOCIETY AT THE MAS H OFTECHNOLOGY MASSACHUSETTS INSTITUTE OF TECHNOLOGY OF T ECHNO JUNE 2005G 1 8 © 2005 Aslihan Sanal All rights reserved LlBA RI The author hereby grants to MIT permission to reproduce and to distribute publicly paper and electronic copies of this thesis document in whole or in part. .I Signatureof Author ......................... ......................... Program inS on-Tcbrology and Society - April 29, 2005 Certified by.... ......... o..................... /7'JgG 1 Michael M J Fischer /\. Jofessor o fAnthropoloy3gnd,Science and Technology Studies Thesis Advisor Certified by ........ ........ ................... U,' I- Harriet Ritvo Professor of History Committee memtber Certified by............ - . ....................................................................... Sherry Turkle Professor of the Social Studies of Science and Technology Committee member Certified by.... ....................................... Joseph Dumit ctC9 Associate Professor of Anthropology Committee member Certifiedby . ........................ .................................... - Jodo Biehl Assistant Professor of Anthropology Princeton University Committee member Accepted by ..... .. ........ ...... ............................................ Rosalind Williams Professor of Writing Director of the Program in Science, Technology, and Society ARCHIVES Flesh Yours, Bones Mine: The making of the Biomedical Subject in Turkey by Aslihan Sanal Submitted to the Program in Science, Technology, and Society on April 29, 2005 in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of History, Anthropology, Science, Technology and Society ABSTRACT With the emergence of biomedical technologies, human body parts from living or dead donors have become commodities in the international networks of trade. This dissertation tries to understand religious, political and ethical discourses on this emerging economy and how it creates its subjects in Turkey. By drawing analogies from the early days of anatomy and mental health practices and by using a three-fold-corpus (state, body and law) as a framework, it illustrates how the state, the religious law on the body, and social inequalities turn some subjects to objects of this biomedical practice while extending life for others. Life histories, oral histories, doctors' and patients' accounts, media reporting, urban legends, cinematography, theater, poetry and literature speak of this new biomedical life. The meaning of the cadaver, the brain-dead body, and the living donor are reevaluated. The personhood of suicides, the homeless, the poor, the mentally ill, the immigrant, and women are all questioned with the redefinition of boundaries of life and death. Biomedicine effects this kind of social change. A cultural history of this production sheds a light onto how Turkey has become one of the centers of organ trafficking in the Middle East in the 1990s, how doctors generate biomedical politics inspired by their American or European counterparts, and how patients, who have acquired kidneys, rationalize and legitimize the world they live in while they seek for "a second life," "a humane treatment," and social equality. Simultaneously new definitions of the human, the person and the self emerge as a new body is reconstructed with parts originating from another human being. It is the history of the biomedicalization of the self. Thesis supervisor: Michael J Fischer Title: Professor of Anthropology, and Science and Technology Studies 2 to my grandmother 3 TABLE OF CONTENTS ACKNOWLEDGMENTS.... ...... .......................................................................... PART I INTRODUCTION: Zfimriid-u Anka ... ...... ...... .. .................. 10 CHAPTER 1 MASAL: or how questions emerge .... .... .. ................................................................19 PART II CHAPTER 2 BUSINESSOF LIFE ......... ...... .. ................... ...................................53 Prologue ....................................................................................................... 53 Transplantation in Turkey ....................................... 61 Launching kidney transplantation.......................................................................................... 62 Istanbul and transplantation from cadavers ................... 6...........................................65 The Ministry and the politics of organ sharing .... ... ...............................................70 Privatizing medicine .......................................................................................... 73 Where to find a kidney ........................................................................................ 78 CHAPTER 3 THE POWER OF DEATH ......... ......................... ..... 89 Thriller.................................... .......... ............................................................89 City of the dead .............................. ............ .................................... 91 Pool of the dead ............................................................. 99 Mehmed... ...................... ............................................................... 103 ]nsanity........................................................................................................ 108 Anatom y......... ............................................................................................ 111 Beyond a mirror ............................................................................................. 117 Effects of truth: dissection and disenchantment .......................................................... 124 Shrinking back ........................................ 128 CHAPTER 4 OBJECTS WITHOUT BIOGRAPHIES ...... ........... ..................................................133 The bone merchant ....................................... 134 Mythsof bone ..... ..... ......................... 144 4 A bone factory................................................................................................. 149 CHAPTER 5 SHARING THE DEAD .................................................................................... 152 Inventing the homeless ...................................................................................... 152 Drama.................................................................... 163 Suicide.................................................................... 168 Sacrifice ................................................................................................................ 174 Medea.................................................................... 180 "The Great Sacrifice" and the interpretative turn ........................................................ 187 Dead body parts, dying metaphors ................................................................ 190 CHAPTER 6 THE LIVING ................................................................... 194 Writing lives ........................................ 197 Kinship paranoia .......................................... 199 The robot ................................................................... 211 Nasib............................................................. 220 Life of the mind .......................................................... 224 Dreams and foreign lands ........................................ 229 Moscow....................................... 236 Istanbul beneath my wings ................................................................................. 241 CONCLUSION.................................................................... 244 BIBLIOGRAPHY.......................................................................................... 252 5 ACKNOWLEDGEMENTS I owe many thanks to a community of scholars in STS and in anthropology at MIT, Harvard and Berkeley for helping me plan, conduct and write this dissertation. I feel lucky to have worked with a unique committee. I thank to my advisor Michael Fischer. He has been an invaluable mentor allowing me to find my way while providing me with his critical intellectual insights. Sherry Turkle has showed me the way to myself in what I write. Harriet Ritvo's mentorship gave me courage to write no matter how hard translations in the cross cultural contexts have been, and helped me understand America. Joe Dumit was a model STS scholar. Joao Biel's comments and criticisms were essential to the fieldwork and the structure of the manuscript. I thank to this committee for their support, encouragement and enthusiasm. My work could not be accomplished without a community of anthropology and history scholars who have been engaged with this project over the several years of research and writing. I thank to Deborah Fitzgerald, David Kaiser, Stefan Helmreich, Jean Jackson, Erica James, Evelyn Fox Keller, Philip Khoury, Leo Marx, Susan Silbey, Merrit Roe Smith, David Mindell, Peter Perdue, Susan Slyomovics, Rosalind Williams, Christine Walley, Charles Weiner. The student body in the STS department and visiting scholars have helped me in various ways. Their humor, strength and faith kept me working. I thank to Etienne Benson, Sandy Brown, Candis Callison, Anita Chan, Xaq Frohlich, Nathan Greenslit,