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Accuracy of Ikiru's Setting

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    O.P.S. Teller

    Those who have seen Kurosawa’s Ikiru (and those who continue reading this) know that the doctor whom the hero visits does not tell him the truth of his condition.

    I am wondering: In reality, would it occur that medical professionals would lie to their clients to discourage the notion of suicide? Would this actually happen in post-war Japan? or is it a fictitious twist added by Akira or, further, by Tolstoy (the author of the book that partly inspired the story of Ikiru)?



    I understand that until quite recently, it was quite common for Japanese doctors not to tell patients they had terminal diseases (as it was nearly everywhere back then). I’m just reading Pico Iyers most recent non-fiction book ‘A Beginners Guide to Japan‘ right now. A direct quote:

    ‘People in American would be upset”, I said to my wife when she informed me that her doctor had just told her, for the first time, that she’d been suffering from a mild form of cervical cancer ten years previously (he’d told her now only because the danger seemed to have passed).
    “Really? she sang back “I thought he was being kind!”

    When, however, Hiroko went into the hospital for a simple infection, nineteen years later, her friends assumed she was struggling with cancer.



    Indeed, that is my understanding as well.

    Don K. Nakayama writes the following in his essay “Professionalism in Kurosawa’s Medical Dramas” (Journal of Surgical Education, November 2009):

    Shimura learns he has terminal cancer indirectly through a series of heartbreaking lies from his doctor. Because of the standards of the day, Japanese physicians would not reveal a terminal diagnosis to a patient, thinking that the bad news will weaken his or her resolve. In not revealing the diagnosis to his patient, the doctor’s lies do not have the intended result. It leaves Shimura utterly alone. The doctor in effect abandons his patient.

    A Japanese movie audience in the 1950s would expect that such news would be withheld. The autonomous unit in Japan was (and mostly remains) the family, and the news about medical diagnoses, especially cancer in an aged family member, was given to the family and not to the patient. Today, we recognize that bad news like a terminal diagnosis can be given to patients honestly yet with compassion. The goal is to spare patients from the uncertainty and isolation depicted in the film.

    If you want to dig deeper, the information about diagnoses being given to the family and not the patient is referenced to: Plotnikoff GA, Amano T. “A culturally appropriate, student-centered curriculum on medical professionalism. Successful innovations at Keio University in Tokyo.”, Minn Med. 2007;90:42-43.

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