A kidney could be the perfect Christmas gift

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Christmas now is drawing near at hand, and your favourite undercover economist has been observed performing some most uncharacteristic acts. My father used to make amazing Christmas puddings and distribute them to his children. Now that he’s dead, I have the recipe and the solemn duty falls to me. Any economics textbook could explain that I am undervaluing my time. I could buy a hundred good puddings with the money I could have earned, had I not been making half a dozen.

Then there is the Harford-Monks Christmas card, designed using a still life created by my wife. And the Harford-Monks Christmas mixtape. (This used to be a true labour of love, requiring dozens of CDs to be burned. Spotify makes life easier, although that somewhat cheapens the ritual.)

No such shortcuts for the Christmas Game, an all-day role-playing game in which, since time immemorial, my friends and I have gathered and pretended to be wizards — often in some seasonally inflected adventure, and always created by one of the group rather than bought off the shelf in a gaming store. This is the way.

I’ve devoted many columns over the years to the “deadweight loss of Christmas” — the grotesque waste involved in buying badly chosen gifts. I remain convinced this loss is quite real, and that if you are choosing a gift for your grandchild or niece, picking from a wishlist or sending cash are underrated choices. Face facts, you’re not demonstrating that you’re down with Gen Alpha, you’re transferring purchasing power.

But there is a different kind of gift-giving going on in homespun rituals. Lewis Hyde’s much-loved book, The Gift, recently gave me a new perspective on the matter. Hyde looks upon creative acts as gifts, and gifts as creative acts. One gift inspires another, he argues, retelling fairy tales to underline the common motif of a small act of generosity which begets a larger one, and a larger one. One story begins with a mother giving a small loaf and a blessing to her daughter; the daughter gives the bread to some birds; a virtuous spiral begins and before the end of the story, she has been gifted with a flask of cordial that can raise the dead. The gift grows as it is passed along.

Hyde devotes a chapter to the way gifts establish bonds between people. This is certainly true of my Christmas game, and is the impulse behind those handcrafted cards, the family pudding recipe and even the endless burning of CDs. One friend insists that the spell of Christmas can only be woven on Christmas Eve by the playing of the Harford-Monks Christmas album with a glass of champagne in hand. Flattery perhaps, but the idea of connecting with that friend compensates for the knowledge that many others will quite reasonably shrug and listen to their own music instead.

Bonds of friendship are all very well, but sometimes bonds can be graver. Consider the connection between kidney donor and kidney recipient: the recipient is literally walking around with part of the donor’s body inside them. (Few gifts, incidentally, create more value than a live kidney donation, where the recipient has their health transformed while the donor usually suffers no more than temporary discomfort. It is the deadweight loss of Christmas in reverse.)

It is easy to romanticise such gifts, but they can be socially complicated. In 2006, the writer Virginia Postrel donated her kidney to Sally Satel — a friend, but “no one would have called us close”. Postrel argued for a legal market in kidneys, and once told me that Satel “would really have liked to do an arms-length transaction with a stranger, where she paid somebody she didn’t know, because there can be a great deal of emotional entanglement when there is a gift”.

Lewis Hyde describes the flip side: a daughter who offered to donate a kidney to her mother, in exchange for a fur coat. “It really shook me up,” said the mother, who agreed to the terms but came to view her own daughter with something close to contempt.

Hyde writes, “the gift did not render the mother subservient to the daughter. And for a good reason: it wasn’t a gift.” The daughter turned it into a barter, and in doing so surrendered her moral authority. Evidently, she preferred the coat.

The gift is neither superior nor inferior to a market transaction; it’s different. Sometimes we want those bonds with others, and use gifts to strengthen them. Sometimes we want to be cut free, and then cash is king.

Cash for kidneys remains frowned upon, but one intriguing development has been the emergence of kidney exchanges.

Cruelly, it’s quite common for people who’ve had children together not to be compatible for transplants, but two couples can pair up and donate to each other. Such exchanges have to be simultaneous, because of the risk that one couple gets the kidney they want and then backs out on the (legally unenforceable) deal.

But much more can be done if someone volunteers to donate a kidney, no strings attached, to any stranger who needs one. That donation can trigger a series of sequential kidney exchanges — in 2015, an altruistic donor, Kathy Hart, started a record-breaking chain of 35 transplants, each one involving a pair of people who received a kidney, then donated one to keep the chain going. That’s a more complicated affair than simply paying cash for a kidney, but everyone seems to feel a lot better about it. One gift inspires another — and the gift grows as it is passed along.

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