Podcast Review: The Gift – Donor

Upon receiving this commission for BioNews, I was struck by the title of the podcast series – The Gift – where journalist Jenny Kleeman continues her exploration of the profound and often unexpected consequences of at-home DNA testing for a second series.

I might be overcautious, but it had never crossed my mind to buy an at-home DNA test as a present. I mostly fear spending money giving the gift of underwhelming information in exchange for a privacy concern. For some people, however, at-home DNA tests results are all but underwhelming.

Kleeman adeptly brings complex identity and kinship topics to life through Tami's personal story in episode five, 'Donor'. A self-described 'story girl' from Texas, Tami is an easy-going speaker that does not shy away from sharing details of her complicated family history – and how some long-buried family secrets are unveiled by fulfilling her fascination with genealogy and extensive use of at-home DNA tests.

'I am the person that, [if] you cannot afford a DNA test, I will give you one', said Tami during the opening of the episode.

Tami's story unfolds against a backdrop of family complexities: Joseph, Tami's father, had divorced Tami's mother and left their home after 16 years of marriage and nine children. Tami had heard stories from her grandmother questioning Joseph's parenthood of some of Tami's siblings. Suspecting Joseph's reasons for leaving, Tami was sympathetic to her father; they reinstated contact and built a strong relationship.

When Joseph's health deteriorates and his kidneys start failing, Tami does not hesitate to offer him one of hers. Despite my initial suspicion of a failed donation process at this point, the story unfolds without major roadblocks: they undergo blood tests – and other compatibility tests – to discover they are a suitable donor-recipient match.

The surprises come later when, in 2013, Tami takes an Ancestry DNA test in an attempt to fill her genealogy tree. She also buys tests for her three daughters, Joseph and his brother's son. The tests reveal that Tami is not Joseph's biological daughter. I disclose this because I doubt it would come as a surprise to anyone as the whole first half of the podcast is a long build-up to this moment.

This revelation sets off a cascade of DNA tests, revealing further familial deceptions for Tami that I will not spoil for you as they do come more as a surprise (one in particular had me and Kleeman gasp in unison!) when compared to the first half of the episode.

The part I found most interesting was the end, where Kleeman's questions steer Tami and her oldest daughter, Amba, into reflecting what these revelations mean for them. Tami is openly resentful of her mother, 'who did a lot of things that weren't good for the family' and died without telling her the truth. Amba recounts how Tami, in need for closure, started a quest for finding her biological father – amazingly, she finds relatives of him, but learns he died many years before.

Despite acknowledging Tami's anger at the lack of answers, Amba offers a contrasting, more forgiving, perspective of her grandmother. She says, 'I don't know why she lived the way she did, but I don't cast judgement on my grandmother. I know she loved me.'

While Tami's feelings of betrayal are powerfully conveyed, the broader implications of her story are only briefly touched upon. For instance, when Tami realises that Joseph is not her biological father, she first rang the transplant coordinator, believing that the transplant hospital may have withheld knowledge about her parentage. I was surprised Kleeman didn't discuss this further, as this level of suspicion could have the potential to erode trust in medical institutions.

As Tami rightly points out during the episode, the DNA databases of these companies have grown to an extent that amplifies their impact on individuals and families, raising questions about consent and privacy (see BioNews 1170 and 1108). These topics are particularly timely after 23andMe announced last November their plans to cut nearly half of their staff after revenues plummeted, generating uncertainty over the fate of the company, and of the genetic data it holds. Similar concerns were raised more recently, when customers of AtlasBiomed were unable to access refunds or DNA reports when the genetic testing company ceased trading (see BioNews 1265).

Overall, Kleeman's second series of The Gift continues to provide thought-provoking insights into the world of at-home DNA testing, harnessing storytelling is an engaging starting point to debates about complex bioethical issues.

Would Tami still have wanted to donate her kidney if she knew of her lack of biological ties to Joseph? Do listen to this episode if you want to find out... and beware that this episode is really worth listening to if you generally enjoy a good piece of gossip, rather than digging into technicalities.