Let's Not Reimagine: Debating Debates about the Necessity of Face Transplants


The Skin I Live In, Sony Pictures Classics, 2011

by Andrea Zittlau

Face/On: Face Transplants and the Ethics of the Other,
by Sharrona Pearl
Chicago: University of Chicago Press, 272 pp.

Sharrona Pearl’s book Face/On looks at the cultural representations of face transplants. It is a fascinating account of media discourses particularly concerning the issue in the United States. In a refreshing writing style that keeps her own voice strong, Pearl promises not only to reveal the mechanisms of institutional normativity by discussing the media discourses about face transplants but also to use the chance “to reimagine what the face means” (p. 5). However, instead of expanding that discussion, Pearl sticks to analyzing the collection of interesting material assembled in the book. In fact, even in her introduction, she states that her book can only be a chronicle that testifies “we’re not there yet,” referring to a world in which appearance is/can be irrelevant (p. 5). At present, face transplants, as Pearl argues, are necessary for those whose faces will distract from normative forms of human interaction.

Pearl begins by discussing the tension between aesthetic surgery and lifesaving operations in the context of transplant medicine. She revisits this controversy throughout her book because its cosmetic nature is the crucial point made against face transplants. By this logic, the face transplant is done for entirely aesthetic reasons and thus not necessary (since not life endangering). Quality of life and the psychological burden of not having a face are not considered, and this is perhaps the most important point Pearl makes while she advocates that our senses—smell, taste, and touch—can be re-experienced after the transplant. While each chapter discusses a different set of themes, they all make the same point that the face transplant is often seen as an unnecessary, and even dangerous, medical intervention, and yet patients clearly cannot participate in life without a face. Pearl is clear in her position: she wants people to be able to participate in life, even without a face. She does not want them to be judged. She does not want the face to play such a strong role in our appearance; in fact, she does not want appearance to play any role at all in human interaction. But because it does, because this is not Pearl’s ideal world, the face transplant is crucial to the way we interact. Making that point, Pearl challenges most media voices whose arguments are not based on philosophical idealism but on supposed medical facts that paint an even darker picture of assumption of human interaction.

The first chapter places her concerns about appearance within the critical literature by, for example, citing Sander Gilman’s work on aesthetic surgery (Making the Body Beautiful: A Cultural History of Aesthetic Surgery [1999]) and Rosemarie Garland Thompson’s ideas about staring (Staring: How We Look [2009]). It also gives an overview of the history of transplants and shows that concerns in connection with the character traits of the donors are irrational. However, discussion of face transplants later in the book show this concern to be the most urgent one.

In a well-written and entertaining chapter 3, Pearl discusses three films from the 1960s, because, as she reveals, the actual medical discourses are informed by the medium of film. Her descriptions of The Face of Another (他人の顔, Tanin no kao, 1966, Japan), Eyes without a Face (Les yeux sans visage, 1960, France) and Seconds (1966, United States) are so compelling that no reader will put the book away without the desire to watch these films. It is interesting that these films use the face transplant to reinvent personalities, and that this of course fails and leads to horrific scenarios, the genre of all three productions. Pearl discusses the issue in detail, but her analysis largely sticks to the narrative of the films, yet The Face of Another has a very interesting camera and collage technique that could be read as another form of transplant.

Chapter 4 looks at the first facial transplant (Isabelle Dinoire, 2005, France) and discusses the responses of the English-language press. Pearl’s critical eye and precision is astute in the way she includes articles from medical journals and discusses them in the same manner as she does the tabloid press. This is a truly ingenious move and helps the medical humanities to legitimize their analysis because her examples vividly illustrate how the medical authors write from the same perspectives and in the same discourses as the tabloid journalists. Her discussions evolve around the necessity, and the risks, of the transplant and debate the psychological consequences of having the face of another. But Pearl then demonstrates that the soft tissue of the face will adjust to bone texture and become more like the original face than the donor face.

Chapter 5 looks at the attention face transplants have received on television, particularly talk shows and interviews that feature patients. Here Pearl is able to show how gender plays into the media attention. While significantly more men have received transplants, women, it seems, make better television footage. The most interesting point Pearl makes is the involvement of the military in providing financial support for face transplant surgery in the United States. While Pearl reveals this connection, she does not expand her discussion to include the fascinating history that the military plays in such medical interventions. The National Museum of Health and Medicine in Washington, DC, is a military museum that shows particularly gruesome facial injuries from World War I, which were exploited by the 1924 anti-war publication Krieg dem Kriege (War against War) by Ernst Friedrich.

As with many topics Pearl touches, she inspires curiosity to look further. As she openly says in her introduction: “Books (like faces and people) are always in the act of becoming. So, please, read this book. And, in so doing, change it” (p. 9).

Piece originally published at H-Net Reviews | Andrea Zittlau. Review of Pearl, Sharrona, Face/On: Face Transplants and the Ethics of the Other. H-Disability, H-Net Reviews. April, 2018. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

About the Author:

Andrea Zittlau is a Lecturer and Postdoctoral Researcher in American Literature and Culture at the University of Rostock.