Troubles of the Heart

Abstract

The Sino-German coproduction Mouzhong leisi yu wode didong: xinshi pianduan explores the medical process of a heart transplant and its aftermath through the Foucauldian theoretical framework of the “clinical gaze.” The doctors’ “biomedical reductionism” is caricatured for its lack of humanness; patients’ physical and emotional agony denies the possibility of peaceful coexistence of the human self and technology. Cynical irony is one way of coping with the identity loss, pain, and techno-human condition of organ-transplant survivors.

Heart Chamber Fragments

A Sino-German Transnational Production

Sitting in a circle on wooden chairs while dressed in translucent lab coats, suggestive of human/robot intermediary life-forms, six male and three female performers pass around a shiny red ball. Their play lasts for a good couple of minutes and looks somewhat like a children’s game. Yet it feels awkward and unnatural. The players throw the ball to each other with precise and stiff moves, lacking the spontaneity of children or of game-playing. As the audience will later realize, the red ball thrown with oddly accurate precision signifies a heart on its way to be transplanted into the body of a patient dependent upon it to survive. The players are doctors meticulously maneuvering the vital organ—the red plastic ball. The only one watching the eerie game, without making a single move, is Aljukić, an actor who suffers from osteogenesis imperfecta (commonly known as “brittle bone disease”) and sometimes performs sitting in a wheelchair. His frail body is also a signifier of a heart on its way to be transplanted into someone else’s frail body. The symmetry between the two signifiers of the heart—a human being sitting motionless and a red plastic ball tossed mindlessly by doctors—is unsettling. The robotic perfection and precision of the medical team in this opening scene is emblematic of the way modern medicine is represented in Paper Tiger Theater Studio’s 2021 performance 某种类似于我的地洞:心室片段 (Mou zhong leisi yu wode didong: xinshi pianduan; Some Kind of Burrow Similar to Myself: Heart Chamber Fragments), commonly referred to in English by its subtitle.

Figure 1. Erwin Aljukić (top) as Manel Palau’s newly transplanted heart. The body and the grafted heart try to coexist. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

The Chinese name of the collective is Zhi Laohu Xiju Gongzuoshi (Paper Tiger Theater Studio). Director Tian Gebing and choreographer Ya’nan Wang relocated to Berlin from Beijing in 2019. The cast for this production comprises Chao Liu, Manel Palau, and Ya’nan Wang; Munich Kammerspiele actors Erwin Aljukić, Svetlana Belesova, Komi Togbonou, Martin Weigel, and Stefan Merki; and independent Malaysian performer Cindy Ng. The collective still engages in various coproductions with mainland China (see for instance Ganran, jiji zhuangtai he Beiduofen; Infection, State of Emergency and Beethoven; Shenzhen, 2021).

Figure 2. Seeing the world through the heart of the donor. The donor’s heart (Erwin Aljukić) “forces” Manel Palau, the recipient, to watch the world through the lens he makes with his hands. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

Staged at Munich Kammerspiele throughout October and November 2021, the dramaturgy of this Sino-German production revolves around the medical act of the heart transplant and its devastating impact on the receiver’s body and sense of identity. The performance explores the theme of extreme medical intervention on the human body through Foucault’s concept of the “clinical gaze” ([1963] 2017), ¹ articulating a cynical binary: on one hand, there are the “cold-blooded” scientists, filtering their patient’s humanity through biomedical parameters, a process that ensures the scientific success of their operation; on the other, there are the troubled, agonized, and psychologically complex patients, objectified by the doctors’ scientific pride and curiosity.

Figure 3. A heart transplant has just been performed. From left: Chao Liu, Svetlana Belesova, Ya’nan Wang, Martin Weigel, Erwin Aljukić, Komi Togbonou, Cindy Ng, Manel Palau. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

As the performance progresses, the doctor/patient dichotomy becomes more and more fraught, yet dissolves into irony and meaninglessness. As Alex Mermikides theorizes in Performance, Medicine and the Human, a new “posthuman self” reemerges as a result of this binary, “in which the medical and the ‘human’ coexist” (2020:26). The new, unsettled self will try vainly to make sense of their post-surgery hybrid identity, only to fail again and again; that is when humor and irony are insinuated as coping mechanisms, dissolving the self-importance that medics and patients alike attribute to themselves: doctors as healers, and patients as tortured victims of technology.

In Heart Chamber Fragments, dramaturg Christoph Lepschy weaves together three different stories meant to “resonate with one another” (in Stecher 2023:203), adapted to express the psychological upheaval that organ transplant patients experience after such invasive new technologies have “intruded upon” their bodies (Tian 2021). The first story is inspired by Jean-Luc Nancy’s essay “L’Intrus” (The Intruder, 1999), in which the French philosopher poetically recounts his personal trauma of having suffered through a heart transplant in the early 1980s. The medical intervention kept him alive for over 30 years; he passed away the very year this production was staged. The second account is inspired by Franz Kafka’s unfinished story “Der Bau” (The Burrow, first published in German in 1931), written during the last months of his life and expressing the agony of his imminent death, in June 1924.²

The third plot line draws on Tao Yuanming’s Jin dynasty fable, Taohua yuanji (The Peach Blossom Spring), China’s first example of utopian literature, dating to the fifth century CE. The story illustrates people’s need to escape political violence. All three narratives mingle with interviews conducted by the crew: with heart transplant survivors who describe their post-surgery experiences; and with various Chinese and German academics and cardiologists who express their perspectives on transplant technologies and their impact on the human body. What unifies these stories, confessions, and expert testimonies is the disruptive power of disease on the patient’s body, and consequently, on their identity.

As its subtitle suggests, the performance is divided into four parts, each corresponding to one of the four chambers of the human heart. The first explores the heart transplant process and the scientific research that made possible this type of breakthrough in modern medicine. The second part performs the struggle of heart transplant patients to adapt to their new schizoid selves, born post-surgery. The third chamber is reserved for the paranoid thoughts before death extracted from Kafka’s “The Burrow” and interwoven with medical accounts of xenotransplantation. And the fourth chamber, that of the millennial old Chinese fable, performs the post-transplant patients’ (in)ability to live in peace with their new human-cyborg hybrid condition. The choreographies uniting all four “chambers” share one core aesthetic principle: the performance of the medical act is juxtaposed with the performance of the emotional impact that this medical procedure has on one’s sense of self. While the team of doctors displays composed, calculated gestures, creating the caricature of “serious” scientists, the patients and direct “beneficiaries” of biomedical progress contort their bodies with awkward moves, crawl, or enter spasmodic trances that reflect their physical and psychological pain and inability to adjust to their new lives. More precisely, the doctors’ “scientific recitals” are limited to cold presentations of just the medical aspects that define their patients’ physiological beings that allow for a successful medical act. At the same time, the psychological components shaping the patients’ identities are ignored with equally cold scientific nonchalance. Such indifference triggers the convoluted body movements of the patients, a sign of their mental fragility.

The interwoven plotlines articulate a series of medical paradoxes that generate a number of questions challenging the ethics of extreme medical interventions on the body: to what extent is it ethical to wait for, or, more accurately, hope for the death of another person so that one’s own life can be saved? What does a dying patient feel like as both lifesaver and life-loser? Is it really doctors’ duty to sympathize with their dying patients? Is it ethical to raise animals for organ transplants to humans? If so, is there a hierarchy among species? Is this alleged human superiority a sign of civilizational progress or its opposite? By insinuating these questions but offering no answers, the performance allows the audience to reflect upon them. To complicate the matter even more, the transcultural aesthetic of this production (de)constructs multiple perspectives on the question of heart transplants—perspectives as different as the three texts by Kafka, Nancy, and Tao. The correlation of literary texts, medical accounts, and interviews—what Rossella Ferrari calls a “rhizomatic model of intercultural theatre” (2020:4)—offers a symphony of visions that deny the possibility of one comprehensive and conclusive perspective on the ethics of modern medicine. The performance resembles a carnival of biometric discourses that ends in dark irony. Irony does not function only as an aesthetic device uniting the melange of narratives; it also represents a means of existing and coexisting with the terrifying awareness that one’s life springs from the death of a complete stranger. Irony is a mechanism of coping with the trauma and paradox of having lost humanity through the very process of a lifesaving procedure such as a heart transplant.

Who are the Paper Tigers?

Founded in 1997 in Beijing, and relocated to Berlin in 2019, Paper Tiger collective started off as part of the so-called experimental theatre (shiyan xiju), avantgarde theatre (xianfeng xiju), or little theatre (xiao juchang) scene that kicked off in China during the opening up after Mao’s death in 1976, beginning in the early 1980s extending into the new millennium. Trying to resist theoretical categorization, especially because of the commercial path independent Chinese theatre has taken since the beginning of the 21st century, the group’s mentor, director Tian Gebing, adopts a type of aesthetic that he defines as “antidramaturgical” and “antitheatre” (Tian 2020), often characterized by Chinese critics as “experimental.” Taking a look at Paper Tiger Theater Studio’s website, one finds that the collective’s theatre praxis relies on “materials from everyday contemporary life” that are “remixed into theatrical reconstruction” and transformed through “deconstruction, transposition, misunderstanding, fictional interpretation and improvisation,” a process that eventually leads the audience to “liberation from conventions” (Paper Tiger Theater n.d.). The collective’s aesthetic took a transcultural turn during the past 10 years with the integration of German dramaturg Christoph Lepschy in the production crew in 2014. ³ The artistic ecologies of other performers from Eastern and Western Europe as well as from other Asian countries who joined the team in time marked the transnational path of Paper Tiger’s aesthetics. Performances such as Feichang Gaoxing (Totally Happy, 2014), Shi Jie (The Decalogue, 2016), and Wubai mi, Kafuka, Chang Cheng, lai zi bu zhenshi shijie de tuxiang (500 Meters: Kafka, Great Wall, Unreal World, 2017) applied new theatre practices that mixed and remixed what Tian claims to be the “theatricality” and “textual” traditions of the European performers with the dense physicality, corporeality, and “agonizing bodily expression” (Tian 2020) of the Chinese actors. These productions share an artistic core that Tian coined as “mutual contextualization” (huwei yujing) (in Zhong 2015).

“Mutual contextualization” is a theatre praxis that brings together various performative styles and traditions so that they interact with each other, imitate each other, define each other through the cultural and social experience of the other, whereas the performers have not much prior knowledge of the traditions. The texts comprising the dramaturgical structure of the productions interact in a similar fashion: in juxtaposition they clash, displace, and replace each other in order to create new meanings. Paper Tiger often infuses their performances with dashes of dark humor arising unexpectedly in the midst of dramatic and nihilistic moments. For example, in 500 Meters, at the end of the show, while one of the performers mimics strangling himself with a rope and gasping for air, he is reciting with his last breath a patriotic line filled with hope. For Paper Tiger, the humor has a double meaning: it proposes a pessimistic and cynical worldview on one hand while conferring a more lucid and ludicrous understanding of the absurd social realities performed onstage on the other.

Heart Chamber Fragments, which is permeated with black humor, reinterprets Kafka’s absurdism in a contemporary, global world. Kafka himself was influenced greatly by Chinese philosophical thought, especially Confucianism and Daoism, and his work equally influenced contemporary Chinese arts (Zeng 2022). In a similar fashion, Tian’s aesthetic is mainly shaped by global theatre ecologies, as he often acknowledges. However, Tian’s productions construct global realities via Chinese ones and the other way round. For Heart Chamber Fragments, both Tian and dramaturg Lepschy conducted documentary and academic research on heart transplants for a couple of years, as it was the case with their previous projects. In 2021, when the Covid-19 pandemic was in full swing, they reunited to remix all their findings into Heart Chamber Fragments. All the pieces of the puzzle that is the performance were collected from various cultural and medical traditions globally to interact transnationally.

Figure 4. Performing a heart transplant. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. Svetlana Belesova, Ya’nan Wang, Martin Weigel, Erwin Aljukić, Komi Togbonou, Cindy Ng, Manel Palau. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

Performing Heart Transplants

Tian Gebing conceptualized the aesthetic framework of the production itself as “a kind of surgery” (in Stecher 2023:203) that dissects the consequences of scientific progress on the human psyche. The medical act of a heart transplant is suggestively evoked in the first fragment of the production by the motto “Listen closely to your heartbeat!” which is displayed on a screen in Chinese and German. Two clashing choreographies intertwine as Munich Kammerspiele actor Stefan Merki announces the arrival of a heart from Paris (presumably to replace the French philosopher’s dying heart). While Merki stands up and recites proudly the medical procedures he is going to perform, choreographer and dancer Wang shakes her body spasmodically, in total contrast to the doctor’s irritatingly calm and composed voice:

Intubation anesthesia, cut the sternum, the pericardium, extract the heart, superior vena cava, superior vena cava cannulation, inferior vena cava cannulation, block the aorta and the inferior vena cava, […] cut two large blood vessels, remove the diseased heart, […] check blood vessel connections, (aortic) canulation, release the aortic clamp, […] ventricular fibrillation. ⁴

As the doctor finishes his exemplary, verbose display of medical knowledge, all of the patients then put on lab coats made of thin, translucent plastic: they turn into doctors ready to perform the procedure. They all disinfect their hands with a frenzy, caricaturing a gesture from the medical professionals’ repertoire, and start marching and chanting an unintelligible sutra. Their cacophony of voices becomes more intelligible as the patients/doctors recount fearful patient experiences of heart transplants (both before and after undergoing the procedure). Few of the lines they chant can be understood by the audience, but the German and Chinese subtitles make it clear that the mix of voices recount individual stories about the anxiety patients felt before the surgery, the physiological problems they confronted in the aftermath of the heart transplant, or the fear of not making the transplant eligibility list or having enough money to pay for the surgery. One of these accounts short-circuits the string of confessions with the deeply troubling and cynical remark at the root of the story: “I am not really waiting for a heart, but rather for another patient to die.” The performers then circle Aljukić’s body (symbolizing here the heart of the dying patient), covering him with their silhouettes. When the operation is over, they lift him up in the air as Aljukić sings an old traditional Serbian ballad about a man whose lover left him to marry someone else, while his own heart “withers” with pain. The Serbian lyrics, displayed onscreen in English, echo the sadness of the moribund patient who gives away his heart in order to save the life of another human being. “You forge another ring/You bury me,/Do I have to die?” are the song’s final words, sung by Aljukić while the doctors take off their plastic outfits and turn again into patients, the bandages still wrapped around their torsos. Such doctor-to-patient metamorphoses point out the ease with which these roles can swap; the sudden transformations bring also to light the fluid and fragile nature defining human beings and how easily they can turn, in the blink of an eye, from humans to cyborgs, from subjects to objects, from “biomedical models” (see Misselbrook 2001:6) to vulnerable human beings. The layered choreography juxtaposes the graphic recital of medical, scientific language with the organic reactions of the patients, while the transitions from patient to doctor happen swiftly, spontaneously, and without fanfare. Stern scientific medical accounts are often uttered against a mise-en-scène filled with bodies that crawl, struggle to walk, mount chairs erratically, and then fall like rocks to the ground, in a repetitive and painful exercise of their new post-surgery lives.

Figure 5. Satisfaction after a successful surgery. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. From front left: Ya’nan Wang, Manel Palau, Erwin Aljukić, Stefan Merki, Komi Togbonou, from back left: Svetlana Belesova, Martin Weigel, Cindy Ng. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

The spectacle of dehumanization through invasive medical procedures is further emphasized by Merki’s scientific promotion of yet another intriguing medical topic: interspecies transplants from baboons and pigs to humans. His engaged speech about the latest discoveries and experiments in this field tackles this highly problematic practice, which is clearly indicative of hierarchies among species and reinforces human beings’ fallacious self-perception. The doctor’s perfect composure emitting an obvious superiority is “counterattacked” by Aljukić’s cascade of questions that dissect, with pathos and sad humor, the darkest ethical aspects of xenotransplantation: “Can people die of a broken heart?” he asks himself. “Can pigs die of a broken heart?” “Can baboons die of a broken heart?” The dark humor of these sad yet aggressive questions unveils the cynicism of doctors’ and physicians’ alleged “biological reductionism” (see Ghaemi 2017). While Merki makes his case in favor of raising pigs, who “only need six months” to grow a transplantable heart, unlike the baboons, who need 10 years, Aljukić dismisses nonchalantly and humorously the barbarism ingrained in the doctor’s argument: “The pig may become the hero who endows you with eternal life.” The symphony of cynicism is then completed with a series of images displayed on a screen at the back of the stage, broadcasting bits of interviews with various Chinese and German heart transplant specialists. Traditional Chinese medicine experts refer to a harmonious correlation among all organs in connection to the heart, whereas one German expert concludes abruptly, short-circuiting the Chinese doctors’ demonstration: “Pigs’ hearts are no good […] Their purpose in our lives is for them to be eaten.” This documentary material juxtaposes with visible ironic effect two incongruent medical discourses: traditional Chinese medicine’s concern with the unity and osmosis among all organs; and the Western medical biometrical perception of the human body as an object. Such a dichotomy has a darkly humorous effect: it subverts the West’s infatuation with scientific progress while at the same time deriding the Chinese traditional belief in a harmonious body.

The switch from dehumanization to rehumanization is Heart Chamber Fragments’ core narrative. This intricate and hyperintellectualized show demonstrates what Barbara Koenig terms as doctors’ “cultural infatuation with technology” ([1988] 2012:466) and the virulent, agonizing effects that modern medicine has on bodies and identities. The misanthropy articulated by Foucault’s “clinical gaze” reveals to heart transplant patients the cruelty of losing their humanness and sense of individual self. After surgery, their perpetual effort is to regain humanness. Will the patients be conquered by their new “posthuman” condition or will they manage to become just themselves again? This question is explored by the three classic texts referenced in the performance.

The “Denial of Reality” and the “Break in the Self”

According to clinical research, one of the most painful consequences of disease is the denial of reality. As Kathlyn Conway states,

[T]he road to acknowledging this radical change involves a complex negotiation between the need to acknowledge the loss of the self and then, paradoxically, to reclaim part of the old self even as a new one develops. Many people deal with shifts in self-conception after radical damage to the body through denial. […A] person whose body is radically changed inevitably perceives the world differently. ([2007] 2013:59, 60)

Similarly, the second part of Heart Chamber Fragments retells Kafka’s “The Burrow” from the perspective of the dying patient, still unreconciled with his own imminent death, marred by paranoia and imaginary enemies, and in a state of complete denial. Kafka wrote this text about a fictitious subterranean creature caught in the frenzy of building a labyrinthine burrow home while he was himself suffering from tuberculosis, which ended his life six months later. “The Burrow” is autobiographical, told in the first person. This character’s frenetic self-protective behavior is perceived by Verne P. Snyder as “tragic,” symptomatic of people’s “inability to alter past experience, coupled with the curse of reliving the fearful past as if it were his unalterable future” (1981:124). The story’s theme of paranoia and anxiety induced by disease is constructed in Heart Chamber Fragments through what Conway terms as a “break in the self” ([2007] 2013:59). In Tian’s understanding, this “break in the self” is “the feeling of danger […] linked to an unknown enemy outside the burrow” (in Stecher 2023:191). The choreographic emphasis on the agony of the body as a consequence of paranoia proves that physical agony is psychological agony, body denial is self-denial, and body rupture is identity rupture. This is shown in the Kafkaesque scene of a brutal dance performed by Malaysian actress Cindy Ng and Munich Kammerspiele actor Martin Weigel. Both wear transparent white shirts, signifiers of their fragile and vulnerable physical and psychological post-surgery condition. Weigel recites fragments from “The Burrow” illustrating the “persecution complex” the protagonist of the story suffers (Snyder 1981:116). The lines he utters are also evocative of Kafka’s narrator’s “anxiety and fear of his unseen, incomprehensible enemy” (1981:125), as illustrated in the following passage:

[…] in reality the burrow does provide a considerable degree of security, but by no means enough, for is one ever free from anxieties inside it? These anxieties are different from ordinary ones, prouder, richer in content, often long repressed, but in their destructive effects they are perhaps much the same as the anxieties that existence in the outer world gives rise to. (Kafka [1931] 1983:367)

While Weigel shares with the audience Kafka’s narrator’s thoughts on his paranoia, as one German reviewer of Heart Chamber Fragments noticed, Ng slips under Weigel’s shirt “as if willing to nest under his ribs” (Leibold 2021) and struggles to stick to his body. She jumps on his back, clings to his legs, while he sweeps the floor with her body, unwilling to let go. Ng’s attempts to adhere to him fail miserably; he throws her fiercely to the ground and disposes of her body as if anxious to get rid of a cancerous lump that may grow bigger and bigger. The violence of this agonizing and savage dance mirrors the psychological violence undergone by a “radically altered self” (Conway [2007] 2013:67) as a consequence of disease. “Sometimes the damage caused to a person’s body is so extreme and functioning so compromised that a person cannot reconcile his or her past and present self” (70).

Similarly, throughout the performance, the failure to make sense of the new self ends in dark irony and abjection. The clash between Ng’s body, thrown to the ground so viciously by an insane, overly suspicious Weigel, is endowed with double meaning, one that connects Kafka’s story to Nancy’s. It is allusive of Kafka’s subterranean character’s “obsession to secure an underground system of passages (the burrow) against imaginary enemies” (Munich Kammerspiele 2021). The creature’s mind, threatened by mortality and disease, is haunted, just like Ng haunts Weigel, by imaginary enemies. The “beast” digging his burrow for more safety is in fact Kafka’s “nickname for disease” (Updike [1983] 1995:11). The paranoia inflicted by sickness is much more threatening to one’s sense of self than the sickness itself. Interpreting this scene from the perspective of Nancy’s “Intruder,” the transplanted heart (here signified by Ng’s spasmodic dance) is incapable of attaching to the new, foreign body (interpreted by Weigel’s desperation to get rid of the new organ harassing him). Ng—the transplanted heart—ends up weaker and weaker, her energies fading, a direct result of the brutality with which her body had been rejected and abused by Weigel’s sickness. The duo’s fight performs the psychological barrier between the sick man in need of a heart and the dead donor’s heart that keeps him alive at the cost of losing the patient’s humanness. As Weigel detaches himself from his frantic clash with Ng and leaves the stage, she goes on harming herself. Her convulsed, spasmodic moves are accompanied by the heart-wrenching rhythm of a melody composed by Polish musician Piotr Kurek. Meanwhile, all the other performers stay seated on chairs at the back of the stage. Lined up in stiff positions they share a microphone and launch, one by one, into a cascade of absurd questions, tainted by a cynical irony that short-circuits Ng’s agony, as she now metamorphoses into the body of a dying patient: “Cindy, do you like your dance?”; “What have you eaten?”; “Would you accept the heart of a pig?”; “Are you a vegetarian?”; “Cindy, what’s under the floor?”; “Do you hurt? Where?”; “Did you have breakfast?” She attempts to answer in Malay each question, but her sentences are unfinished gibberish. Finally, her body, slowly but surely, becomes completely motionless. The drama of losing one’s identity as a consequence of disease (as signified by this scene) eventually gets ridiculed by the way in which Ng is harassed with never-ending, futile, heartless questions that seem to brush off and deny the misery of her sickness.

A similar image of the inability to grasp the new realities of the self in a post-surgery world is constructed in a previous scene when Manel Palau, a Spanish dancer, and Aljukić move in and out of sync. Palau embodies the heart transplant receiver, while Aljukić represents Palau’s newly transplanted heart. His body is so “fragile” that one “fears” for his safety, as the German critic Christoph Leibold remarked (Leibold 2021). Palau’s and Aljukić’s half-synchronized moves are suggestive of Nancy’s own struggle to forget his former, healthy self, and come to terms with his extremely strange and estranging identity. The two performers follow each other—mimic each other—despite their inability to accept each other. Palau seems threatened by the moves of his foreign heart and realizes, just like Kafka’s subterranean beast, that his worst enemy is himself; that his attempts to forget the past and reconfigure, reembody, and reembrace life after the trauma of the surgery are doomed to failure. Aljukić clings to Palau’s back, as Palau crawls on the ground, desperate to shake off the “creature” that attaches like a parasite to his body. The Spaniard’s moves back and forth on his knees, his crawling, rolling, or walking are all dictated by Aljukić’s whims, who indicates with precise gestures the type of moves Palau is expected to make. Aljukić’s hands even take the shape of a loop through the lens of which Palau is now forced to see the world. The struggle to tame and accept the intruder creating havoc in his body comes to odds with the fact that it is this very same intruder, namely his new heart, that makes his life possible. As Nancy confesses in “The Intruder,” the heart transplant experience alienated him from himself:

Becoming a stranger to myself does not draw me closer to the intruder. Rather it would appear that a general law of intrusion is being revealed. There has never been just one intrusion: as soon as one is produced, it multiplies itself […] Strangeness and being a stranger, become common, everyday things. (Nancy [1999] 2008:167)

The painful paradox of life born out of death denies the host body any possibility of relief.

The pair’s dance is later resumed in the third part of the performance, which is dedicated to Nancy’s heart transplant trauma. For Nancy, the heart, or “the gift of life” was “an intruder” that enables the patient’s “drive to survive” (Wynn 2009:8). The third heart chamber fragment begins with a quote from the French philosopher’s confessional story: “After they told me I needed a graft [transplant], […] the physical sensation of a void already opened up in the chest” ([1999] 2008:162). For this scene, Palau and Aljukić move in sync as they perform a heart-body reconciliatory dance to the haunting music composed by Kurek. Palau takes a few steps forward; Aljukić moves ahead in his wheelchair; Palau closes and opens his fist to check if he can still feel his hands, as does Aljukić as if mirroring him. Other pairs of performers move with perfectly synchronized gestures as well. For instance, Togbonou and Weigel talk to each other and follow each other in synchrony, moving in circles around the stage while reciting passages from Nancy’s “Intruder”: “How does one decide, and who decides, when a graft (transplant), suitable for more than one graftee (receiver), is available? Here we know that the demand exceeds the supply” (164). Their moves are in sync but clumsy, lacking direction, while their dialog, performed mechanically, is uttered in haste, overtly failing to capture the emotionality of Nancy’s account. The choreographic incongruencies render his confessions humorous and absurd. Wang and Ng move in sync as well while they contort their bodies, crawl, jump up, lie on their backs, or struggle to breathe. However, their gestural harmony slowly disintegrates. All of the couples engaged in simultaneous movements separate at some point, each following their own spasmodic repertoire—a sign of yet another failed attempt to rebalance their post-surgery condition in the newly hybridized bodies. The choreography may at first lead the audience to believe that slowly but surely the heart and its recipient become one entity, only to diverge unexpectedly, precisely when it seems that organic harmony is possible.

Figure 6. Getting drawn into the swirl created by the sea of rosy petals in the utopian land of “The Peach Blossom Spring.” From left: Komi Togbonou, Martin Weigel, Cindy Ng, Ya’nan Wang, Manel Palau. 心室片段 / Heart Chamber Fragments, Munich Kammerspiele, 2021. (Photo by Hua Dong; courtesy of Paper Tiger Theater)

A Body’s Techno-Human Post-Surgery Condition or Another Peach Blossom Spring Utopia

Utopia is the main theme of the fourth and last “chamber” of Heart Chamber Fragments. This chamber investigates the psychological aftermath of a heart transplant from the perspective of the famous fourth-century Chinese fable, The Peach Blossom Spring. Chinese poet Tao Yuanming constructed in this story an arcadian space born out of people’s “desire to escape from contemporary political turmoil” (Fu 2022) during the bloody, martial times of the Qin dynasty (221–206 BCE). In Tao’s land of eternal peace, people are completely isolated from the brutality of the outside world from which their ancestors escaped.

Tian imagined the “open space” in the Chinese fable as a continuation of Kafka’s “The Burrow” in the form of a “closed, interior space” (in Stecher 2023:201). Heart Chamber Fragments translates this escapist utopia metaphor into “a ghost world” with no return, a place “that imagines the world outside as extremely dangerous” (201). As the performers crawl and pull out the wooden planks of the stage floor, underneath they discover a densely packed mass of small, solid, pink pellets, echoing the shiny, rosy utopian petal landscape of The Peach Blossom Spring. Dressed in transparent white shirts, the performers line up at the back of the stage, behind a row of chairs, and move their bodies lethargically, spreading their limbs as if under the influence of a potent pill that slows down their movement and turns them into sleep-walking ghosts. They simultaneously quote passages from Nancy’s realization that his post-surgery identity and the disease he was cured of are one and the same thing.

While this spectacle of heart misery unfolds, a woman walks unexpectedly from the audience to the middle of the stage and disappears in a matter of seconds straight into the sea of pink pellets that shockingly engulf her. She submerges under the pellets composing the Peach Blossom Land, drawn by a swirl formed on the stage floor. Following suit, the other performers are slowly absorbed inside the swirl of the peach petals. Their transparent white clothing and their contorted and sluggish yet fluid moves as they submerge in the pellets give them the appearance of living ghosts gradually failing to regain their former human condition. Tao Yuanming’s utopian land of eternal peace is in Tian’s rendition a land where ghosts escape from the violence of reality. The performers seem to resist descending into the swirling mass of pellets, yet desirous to do so. It is up to the audience to make sense of what is happening to them and what prompted the woman to voluntarily step into the unknown of this ghostly otherworld. Reviewer Brian Haman commented that “the performers are slowly swallowed by gravity’s downward force, with one walking voluntarily into the abyss. Has she discovered her utopia or been buried by her delusions?” (2021). Equally, one may feel entitled to ask further: Can a heart-transplant survivor really embrace the unknown as willingly as the woman who submerges herself in the Peach Blossom utopia? Or maybe she must first go through a long, painful process of denial? Heart Chamber Fragments leaves open many questions that time itself will fail to answer.

Figure 7. Svetlana Belesova engulfed in the “peach petals” of Tao Yuanming’s utopian land of “The Peach Blossom Spring.” Heart Chamber Fragments / 心室片段, Munich Kammerspiele, 2021. (Photo by Judith Buss; courtesy of Paper Tiger Theater)

Heart’s Failure to Embrace Medicine’s Techno-Salvation

What an Irony!

The three-layered narrative framework of the dramaturgy is constructed as a reaction to the reductionist model of patients’ sense of self by the medical world, and, through extrapolation, by science. This is also reflected in the choreography: the contrast of the stiff mechanistic movement of characters who represent science; as opposed to the organic model of individuality. The new self that emerges from the struggle between the human condition and biometrics proposes thus the formation of a “techno-infused” body (see Parker-Starbuck 2011:17), illustrative of the “historic weaving together of the corporeal and the technological” (9). In Heart Chamber Fragments the technology and humanity coexist indeed, but their coexistence is tragic and ridiculous, as the many incongruities and influxes of humor suggest. In one of the last scenes, all performers identify themselves with the illness they carry, while reciting in chorus, as if a team of cyborgs reciting a sutra, fragments from Nancy’s own painful realization: “I am the illness and the medicine, I am the cancerous cell and the grafted organ. I am these immune-depressive agents and their palliatives” ([1999] 2008:170). In the end, no(body) finds peace with this new techno-hybrid way of functioning in the world. The open-ended and ambiguous final scenes speak both to patients and doctors alike without lecturing, but rather mocking them.

A heart transplant disrupts and denies reality, multiplies the self, creates gaps in it, refuses the possibility of a past and a future, and radically alters one’s individuality. The psychological, anthropological, and medical data that characterize the literary, biographical, or scientific texts collaged in this performance are infused with poetic imagery and a great dose of sarcasm and dark irony when juxtaposed to the spasmodic bodies of the patients. The compilation of aesthetic strategies in Heart Chamber Fragments proposes new modes of understanding the diseased body and its impact on identity. The performers mimic with parodic effect the scientific precision found in medical and biomedical literature, unmaking the caricatural image that lies behind the scientific entitlement of modern medicine. At the same time patients’ psychological effort to cope with sickness and to get used to their post-surgery hybridization and robotization is not spared any irony, either. The dark, absurd, and cynical humor of doctors and patients invalidating each other’s perceptions of disease becomes a heart transplant coping strategy. Any clear-cut, factual, sound theory regarding the sick body’s “correct,” “natural,” and “ethical” response to disease or the possibility of their performative representation remains, simply, a utopia. In Tian’s words, managing the self and the body after a heart transplant surgery is like delving into “a ghost world” (2021), where one just vanishes without a trace.