“A Procedure Without a Problem,” or, The Face Transplant That Didn’t Happen : The Royal Free, the Royal College of Surgeons and the Challenge of Surgical Firsts

Face transplants are an innovative and unusual form of modern surgery. There have been 47 face transplants around the world to date, but none as yet in the UK. Yet in 2003, the UK was poised to undertake the first face transplant in the world. The reasons why it didn't take place are not straightforward, but largely unexplored by historians. The Royal College of Surgeons, concerned about the media attention given to face transplants and the ethical and surgical issues involved, held a working party and concluded that it could not give approval for face transplants, effectively bringing to a halt the UK's momentum in the field. This extraordinary episode in medical history has been anecdotally influential in shaping the course of British surgical history. This article explores and explains the lack of a face transplant in the UK and draws attention to the complex emotional, institutional and international issues involved. Its findings have implications beyond the theme of face transplants, into the cultural contexts and practices in which surgical innovation takes place

Central importance of emotional and quality-of-life outcomes in the public’s perception of face transplantation

Face transplantation is a surgical innovation to manage people with severely interrupted facial function and form. How the public perceive face transplantation and its potential implications for the recipient, donor, and society is unclear. The aim of this study was to understand the public perception of face transplantation, including when it is appropriate, what information is required to feel adequately informed, and which factors influence a person's willingness to donate their face. This was a nationwide survey of participants representative of the GB public. A quantitative analysis was performed. Free-text qualitative responses were coded with thematic content analysis and a narrative analysis was constructed. The survey included 2122 participants. Face transplantation was considered worth the potential risks if it improved an individual's quality of life, gave them a 'normal life', and/or increased their confidence and social interaction. Respondents were worried about the impact face transplantation might have on donor families, especially recipient families adapting to the identity of the donor. Respondents most concerned about the concept of face transplantation were aged at least 55 years (χ2(4) = 38.9, P < 0.001), women (χ2(1) = 19.8, P < 0.001), and Indian/Asian (χ2(4) = 11.9, P = 0.016). The public perceive emotional and psychological outcomes as equally as important as, or more important than, surgical outcomes when determining the appropriateness of face transplantation. Future research should focus on measuring and describing emotional and psychological outcomes after face transplantation. [Abstract copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.

An "Angry and Malicious Mind"? Narratives of Slander at the Church Courts of York, c.1660-c.1760.

This article explores the role and significance of the emotion of anger in slander litigation in the late seventeenth and early eighteenth-century church courts. It argues that existing historiographies place insufficient emphasis on the shaping mechanisms of legal and court process in the production of narratives of complaint. For rather than being incidental or ‘background’ information to dispute, the existence of an ‘angry and malicious mind’ was fundamental to the definition of slander under ecclesiastical law. This claim has implications for historians of emotion more generally, as it reveals the complex traditions of emotion beliefs in specific discursive fields in the past, and the (related) difficulties of accessing or interpreting individual ‘feelings’ through the historical record. Yet in proving the existence of ‘anger’ in slander disputes, contemporaries cited as evidence a range of communicative displays – from the volume and pitch of voice used by the defendant to the physical distance between disputants – that have seldom been considered as part of emotional embodiment. Analysis of such strategies allows us to explore the meanings of anger as socially constituted in and through the realm of practice