Leave it to the Burbank's Alliance Repertory Company, a theater with a reputation for melding dramatic substance with sentience, to offer up a new play (now in its third week) about organ transplantation -- a topic that no one can cuddle up to, an issue, at least on the stage, more discomfiting than fatal illness and less romantic than death itself (both of which we're used to seeing on the boards).
With neither inherent dramatic grace nor certainty of resolution, to say nothing of clear-cut protagonists, A Heart of Flesh involves stricken people sitting around and waiting for organs to become available; that's pretty much the story. Except that playwright Angelo Parra has focused the story not on the hopeful transplant recipients, but on a hospital ethics committee that makes the decisions about who gets the organs.
Heart tells the tale of seven people who make up such a panel at a major hospital and whose job it is to vote on which patient gets the next available heart, liver, lung or pancreas. With the list of needy patients exceeding organ availability, tempers fly, wills clash, and God complexes get tossed around the committee conference table like hot potatoes.
The immediate choice the panel must make is freighted with more moral questions than usual because they must decide who is more deserving of a newly available heart: a 10-year-old black girl in otherwise good health or an aged, fast-living Latino superstar entertainer who promises that if he gets the organ, he'll spend a year doing a benefit concert tour for organ donation. To complicate matters, the hospital has recently endured criticism for giving a double transplant to another high-profile case, the state's governor.
The young girl's mother agitates from outside the institution for her daughter, while the chief transplant surgeon -- a believer in the poster-boy strategy and also an influential member of the committee -- pushes for the singer, who he believes will raise public awareness of the donation crisis and prove more beneficial to the cause.
The others on this ethnically diverse jury have their reasons for their votes, which include racial fealty and political interests, but the rub is in how those reasons continually shift and bleed into each other. Dangling above the story like a carrot is an ideal called objectivity; like its sister ideal of democracy, it proves to be something noble to strive for but a bitch to reach.
The central question that emerges is ugly but fascinating: How best to determine the worthiness of one life over another? There's no answer, of course, but the scope of the question is metaphysical, and watching the actors go through the Rubik's Cube of reasoning is guaranteed to at least generate some interesting post-play discussion.
A Heart of Flesh garnered distinction before being developed at the Alliance: It won the David James Ellis Award for best script, and also took the prize in the Jewel Box Theater (Oklahoma City) and the Mixed Blood Versus America (Minneapolis) playwriting competitions.
Parra, 51, says he was inspired to write the play six years ago after a stint as a freelance communications writer for a large pharmaceutical company. As part of the job, he was once allowed to sit in on a hospital's patient- and ethics-review committee, which met weekly to make organ-transplant decisions. What struck him was not the passion of the process, but the dispassion.
"As I listened to the considerations, it occurred to me that these people would have these great decisions to make, but in a way it was like any other job," he says. "Like a brain surgeon who makes life-and-death decisions that become automatic, routine."
What particularly intrigued Parra about the committee was that, with the exception of the transplant surgeon, it was made up not of medical professionals but of relatively plain folk hailing from all walks of life. One of the things he discovered in the three years he spent â researching organ-transplantation procedures is that race often does play a role -- no big surprise, but a sobering thought nonetheless. "Do you vote your race, or do vote your conscience?" muses Parra, who is himself Latino. That great American quandary is inevitably brought to bear here because "the bottom line is that there just aren't enough organs to go around."
"WHAT IS FAIRNESS? THE BOTTOM LINE is that fair is a feeling, not an absolute," says director Robert Mandan. "It's a sliding scale." Hospital committees do employ objective criteria when awarding organs -- the patient's blood type, need, geographical proximity to the organ. "But with those being equal, great variables come into the picture." Mandan elaborates: "Everyone claims there are no social or personal factors involved. That's not true -- the white power elite gets what it wants and needs." In the play, "There's a black minister, an Al Sharpton type, publicly protesting the transplant process, who's trying to get what he and his community want. But there really isn't a right or a wrong decision."
As it turns out, Alliance Rep is presenting A Heart of Flesh at a serendipitous moment: One of the company's actors, Arnie Starkey, is currently on the organ-donation list for a kidney. Starkey had planned to audition for the new play, but fell too ill to do so. The situation was never discussed in rehearsals, though actor Robin Middleton believes it gave the production a dimension of urgency it did not have in the year or so the script was being circulated at the theater, admired but unproduced.
True to the humanitarian bent it's displayed since opening in 1986, Alliance Rep is working with a local organ-donation organization, handing out donor cards to audiences during the length of Heart's run. Early returns suggest that the issue is more emotionally volatile than most people care to admit: Middleton says that during the staged readings of the play, "We got loud discussions and protests. Some people who saw it who were on organ-donor lists took themselves off."
While such an impassioned response is always welcome in the theater, there is always the danger of a work like Heart being more propaganda than play; the social, ethnic and medical considerations surrounding organ transplants are certainly weighty enough on their own to displace any real human story.
Parra says he consciously worked against that by "focusing on the stories of the people who have to make the choice. There's even a bit of humor in the whole thing."
True. You have to admit that there's a grisly kind of amusement to white patients' concerns over being tainted by a black or other ethnic heart, or to people's fear that the medical establishment might too readily harvest the organs of an incapacitated person with a donor card who's still alive.
Mandan and Middleton say what matters most is the play's impact on the audience's heart, brain, gut . . . and any other feeling body part. "After those first readings, I thought, 'This is what we want, a dialogue that goes out of the theater,'" says Middleton. "We want people to leave thinking and feeling something besides 'So, where are we going for dinner?'"
A Heart of Flesh plays Thursdays through Saturdays at 8 p.m. through August 21 at the Alliance Repertory Company, 3204 W. Magnolia Blvd., Burbank; (323) 655-TKTS. (For the review, see New Theater Reviews in the Calendar section.)