Time and again, Helen Yokoyama displayed an instinctive ability to grasp the significance of an occasion and know what was called for to make things work for the Maidens. She had proven to be a pivotal person whose sensitivity and acuity was capable of rescuing an immediate emotional reaction from escalating into an ugly conflict, converting it into a detailed illustration of the diversity among people of different backgrounds and orientations — and in such a way as to bring about a respect for those differences. It was why the Maidens called her Sensei, a Japanese term respectfully reserved for master teachers. She had had numerous opportunities to talk with the Americans involved in the project, and it was her conclusion that while their motives were multifaceted and there were probably a few who were making a political statement through their participation in this project, most were simply acting in accordance with a tradition of philanthropy. “Yes, these are people who deplore war,” she replied. “But I don’t believe this is the only reason for their involvement. I think they volunteered because they are people responsive to human suffering.”
The girls were not satisfied. Historically, philanthropy was an alien cultural and philosophical concept in Japan. A traditional reluctance to get involved in the troubles of others, plus the absence of the “Good Samaritan” ethic in Japanese religion, generally explained why there were so few philanthropic foundations or programs in Japan. While the Japanese had a strong sense of obligation in certain situations, such as to Emperor and family, they were largely lacking in feelings of altruism. “But they take me into their homes and treat me as though I belonged to their family. It is not their duty to do this. It is not their duty to give me expensive medical treatment. Why do they want to do all this?” asked one girl.
“Suppose,” Helen Yokoyama said, “that some people have a philosophy of life which enables them to regard all human beings as belonging to a single family. Even though they might not know each other, even though they might live thousands of miles apart, they might still believe in their closeness to one another and in their obligations to one another. The same love that members of a family feel for one another can be felt by these people for all others, especially for those who are terribly in need of help. Is this not possible?”
“You mean that these people are helping me because they love me?”
“I believe they do.”
It was a different way of thinking than the girls were used to. At that time in Japan the term love was used only to describe relationships between members of the opposite sex and within a family, and never applied to humanity. So Helen Yokoyama thought surely the girls would have difficulty absorbing the meaning of the concept of a love for mankind, and suspect some ulterior motive. But to her surprise and delight she found she was wrong about that.
At first she thought maybe the girls were receptive to the idea because they had not been exposed to people and ideas in Japan — ostracized in the community, their schooling interrupted, they had been unable to feel much of anything other than their own misery. But when she visited them in their American homes and saw them sitting by the hearth in cashmere sweaters and tweed skirts, speaking joyfully of their present lives, she knew where the explanation lay. The experience of being cared for and made to feel wanted had brought out a creative growth in their response to life and other people. Being loved had re-established their own capacity for loving.
The transformation of Michiko Sako was a golden example of the regenerative power of human love. She was a country girl, orphaned at the age of eight when her mother died of tuberculosis, the same disease that had claimed her father two years earlier. Their tragic passing was just the latest in a series of premature deaths that had plagued the Sako family history with the constancy of a curse; when a freshman, Michiko wrote an essay about her tragic heritage that was awarded first prize in a high school writing contest. Until that time, few of her classmates knew of her “dark side,” and from that day on she felt she walked around school with an aura of difference that was directly tied to the old feudal prejudice against orphans. It was just the beginning of a life of gradual withdrawal and alienation that culminated with the atomic bombing. Michiko Sako was the girl whose scars pulled tautly at the corners of her mouth, making it physically impossible to smile — inspiring her to write the poem “Smile, Please Come Back” that had been made into a hit record. Even if she had been able, there was nothing in the ten years after the war that Michiko would have felt like smiling at. All that changed in America, however, where she found herself taken in by a white-haired, ruddy-faced gentleman who looked like Robert Frost and shared the poet’s love of nature and hobby of watching wildlife, and his petite, gray-haired wife, Vesta, who lived up to her namesake, the Greek goddess of the hearth, with her love of cooking. The couple had been unable to have children, but without affectation, as if it was the most natural thing in the world, Michiko Sako became the daughter they had never had, and they the parents she had lost. They took her into their lives completely. The language barrier did not prevent basic understandings; to the contrary, the way blindness makes a person more sensitive to sounds and smells, communicating without words forced them to rely on expressions and vibrations to know what the other was feeling and saying, which often led to finer understandings. Almost physically, Michiko felt other barriers breaking, built up through the years of loneliness and desperation, under the touch of this elderly couple. It was like a second upbringing that opened her mind to new ways of thinking and gave her a different view of herself and the world.
Michiko was in the hospital when Mother’s Day came around, but she made sure that her American mother received a greeting card on that day. It was the first ever for Vesta, and she regarded it as one of her most treasured keepsakes. “When I die, if nothing else is put in my coffin, be sure to put this card in,” she told her husband; and when she phoned her Japanese daughter to thank her, she repeated that line. Michiko’s reaction was normal enough, but in her case it seemed as though a miracle took place, as the emotions recently released inside her combined with her restored capacity for physical expressiveness to permit a smile.
From time to time it did occur to some of the Maidens that they were looking upon America at its best and only seeing the sunny side of this country. And hearing from the Japanese-Americans who visited them in the hospital what it had been like living in resettlement camps during the war made it all more believable. And there were occasional episodes that let them know Americans were capable of contradicting the ideals they allegedly stood for, of turning their backs on some while opening their arms to others. Two girls who stayed for a period of time with an interracial couple saw racial discrimination in action one evening when they were taken out to dinner and the husband, a black man who worked at the United Nations, was refused service (the irony that there was a stronger bias against black Americans than against foreigners from a former enemy nation was not wasted). Hiroko Tasaka realized she was being given a first-class view of America the evening Dr. Hitzig took her and three other girls to a ritzy New York restaurant where they were served by uniformed waiters who were as attentive to their desires as a circle of admirers. After a sociable drink they were shown menus, and when they expressed concern about the prices and discussed among themselves whether they should limit their orders to an appetizer, Dr. Hitzig told them to order what they wanted, all that mattered was that they enjoy themselves. It was almost midnight when he sent them home in a taxi, and Hiroko sighed happily as she watched the colored lights of the city flow past in a rainbow blur. It had been a delightful evening and she was savoring the memory and the tastes when the cab stopped for a red light and she found herself staring out the window at a gaunt, unshaven man in a brown overcoat who stood rummaging through a trash can. His image remained in her mind, for she could not get over how, immediately after an evening in which she had been so indulged and pampered, she could be watching a derelict scrounge for scraps. She felt too good to let the experience dilute the pleasure o
f the evening for her and too tired to try to extract some profound meaning from it; but something was stirred inside her that made her feel it was important to remember that even in America poverty and wealth lived side by side, and there seemed to be no justice in its distribution.
And then, as if to disabuse them of the notion that American medicine was infallible, the project took a tragic turn.
The original plan had called for the operations to be finished at the end of one year. The girls were told this, as were the people of Hiroshima. But by early spring it was clear they were far behind schedule. The problem was not the slowness of surgery (the surgeons were working in teams, sometimes performing two operations simultaneously, Dr. Simon or Kahn on the hand, Dr. Barsky on the face); the bottleneck was created because there were only four beds available to them. Since each girl remained in the hospital for as long as a week after her operation, there was a necessary wait until a new patient could be accommodated.
Barsky had appealed to the hospital administration for additional beds but had been told that they could not afford to give away any more space to the Hiroshima Maidens. In order to vacate the beds sooner, he had set up a clinic where treatment that did not specifically require hospitalization (bandages changed, stitches removed) was given, and that had relieved the pressure some. Nevertheless, when Norman Cousins wanted to know how close the girls were to their return, Barsky had to tell him that the whole group would not be ready to go back until the end of the summer at the earliest.
Cousins saw this as a problem. Already a year had passed, the length of time he had originally estimated it could take to complete the surgery, and he felt it was important that they keep their word; people in Japan were waiting. Barsky said he understood, but he felt it would be a mistake to send the girls back with scabs or great discolorations on their faces. “What about sending them back in two groups then?” Cousins suggested. “Those cases that are essentially done can return on schedule, the rest can stay until the end of summer.” Barsky had no objection to this, and even thought a staged return could work to their advantage. This way they could observe the impact of the first girls to return on the Japanese people, their families, and the medical profession over there.
In general, there had been less to be done on those girls who were scheduled to return early. But when their names were announced, one of them, Tomoko Nakabayashi, rushed to Dr. Barsky and begged for one more operation. Tomoko had been fourteen and running an errand for her grandmother in the business district of the city when the bomb fell on Hiroshima, and although she suffered no facial disfiguration, her arms were badly burned and her right hand was left bent and twisted. For ten years she had worn long “opera gloves” to conceal her injury, but her year in New York had made that unnecessary. Her entire outlook had brightened, but there remained a long white scar on the inside of her forearm that she said would keep her from wearing short-sleeved blouses, so she wanted a third operation.
“You don’t really need it,” Dr. Barsky told her.
Tomoko pleaded. “If it is so slight, then certainly the effort on the part of the doctors is not so great. Please.”
With a shrug of his shoulders, Barsky said that since it was a minor procedure he would try to slip her into the schedule. Overjoyed, Tomoko danced around the ward, but her celebration was too hasty.
Many years later, Dr. Barsky would set the stage for what went wrong with Tomoko by simply stating, “When there is not eternal vigilance with anesthesia, there is trouble.” Indeed, early in his career, in an effort to keep everyone in the operating room aware that there was a patient under general anesthesia, he had developed a crude device for monitoring a patient’s pulse. He wanted to rig up a visible signal, like a small light that would throb and click to the beat of a patient’s heart. He happened to have a young patient in the hospital at the time who was an electrical engineer, and he talked it over with him and they came up with a device that hung on the wall, was connected to a patient’s opposite foot or hand, and flashed and clicked in time with the heartbeat. It looked for a while like they had invented the prototype for a new, inexpensive operating room feature — until the day a nurse unhooked the patient before she unplugged the cord and the light continued to flash and click, flash and click. It seemed all this time they had been picking up the oscillations of the alternating current. Subsequently, a more reliable pulse monitor was developed, but at the time of the Hiroshima Maidens Project the operating surgeon depended on the anesthetist to keep track of life signs. And if he was operating on an extremity he was even more dependent on the anesthetist because the patient’s face was usually screened by a sheet, and he would probably be operating under a tourniquet, so he was working in a bloodless field.
The operation on Tomoko Nakabayashi began early on the afternoon of May 24, 1956. After the anesthesia was administered, Dr. Simon tied a tourniquet around her arm and began surgery. The procedure was not complicated, and he was midway through when he noticed the anesthetist frantically pumping the oxygen bag.
“What’s going on?” he asked.
“She’s too light,” the anesthetist answered. Then he said, “She’s stopped breathing.”
Simon moved swiftly to the other side of the table. He did not hesitate because he sensed what had happened and knew time was of the essence. Within thirty seconds he had Tomoko Nakabayashi’s chest cavity open and he was massaging her heart with his hands. He was getting no response so he turned to the help of a defribillator, a device that helped electrically activate the heart. It worked, he was able to get a complete restoration of a heartbeat, but he did not know how much good it would be because according to his calculations she had gone without oxygen for more than ten minutes.
Everything that could be done for Tomoko was done. She was placed in a respirator in the recovery room at Mount Sinai, where a mechanical lung kept her breathing. On top of the long steel-and-glass tube in which the frail, waxen Tomoko lay was a gauge, its black arm swinging inside a narrow range. Underneath the respirator were the bellows. A battery of doctors and nurses kept watch over her.
Norman Cousins was called and he came over to the hospital immediately. Nurses who were scheduled to go off duty at 4 p.m. asked to be allowed to stay. Specialists came and went. Everyone hoped for the best, but it was apparent that these were the last moments of her life.
At 7:30, a priest arrived to administer the last rites. Of the twenty-five girls, Tomoko was the only Catholic.
For another two hours the instruments said she was still alive. Around 9:30, Cousins opened the door to the recovery room and looked in. The bellows were still going and the black hand in the indicator was flickering feebly. Dr. Simon was standing over the respirator. He looked up and shook his head. After another minute the indicator stopped.
*
It was a newsworthy death, BEAUTY HUNT FATAL — HIROSHIMA MAIDEN DIES IN SURGERY topped a front-page obituary. Various repercussions were expected in Japan, so the New York City coroner asked a Japanese pathologist at Mount Sinai to assist with the postmortem. Their autopsy report concluded Tomoko had died of unexpected cardiac arrest and respiratory failure under anesthesia. The foreign offices of Japanese newspapers in the States seemed dissatisfied with the official releases. Citing medical sources in Japan who claimed female hibakusha, or survivors of the atomic bomb, suffered from a syndrome that rendered them periodically sensitive to heart failure, they demanded further details. In response, the medical examiner issued a statement: “There was no evidence of any structural damage to the heart, brain, or other organs attributable to a radiation effect of the atomic bomb explosion in 1945 which resulted in the thermal burns, the complications of which necessitated reconstructive surgery.”
The story was kept alive by leftists in Japan who led the charge of treachery, accusing Americans of killing Tomoko twice, and calling for the return of the Maidens before any more died at the hands of American technicians. It was not the majority opinion, but there was concer
n at Hiroshima City Hall that the pitch and venom of the rhetoric could poison public perceptions of the project. A sad note was added when, a week after Tomoko’s death, her final letter arrived at the home of her parents. They found it lying in a stack of letters of condolence sent from people all over Japan. It had been written and mailed the day before her fatal surgery and in it she had sounded excited because the American doctors had agreed to give her one last unscheduled operation to eliminate the traces of the previous surgery.
Meanwhile, in New York the gathering clouds created a crisis atmosphere. Norman Cousins was deeply shaken and felt he was to blame for Tomoko’s death. The American doctors were heartsick. At a steering committee meeting the possibility that the entire project would collapse was discussed. Naturally the remaining twenty-four girls were upset, and no one knew what their reaction would be, or what should be done if the girl scheduled next for an operation declined further surgery.
As tragic as Tomoko’s death was, Helen Yokoyama consoled herself by remembering that Tomoko had gotten what she wanted and died a happy girl. A lovely light had gone out, but she felt some good must come out of it because she did not want this unfortunate accident to ruin an effort that had been triumphant in every other way. So she went by herself to the ward to have a talk with the other girls.
Next on the schedule was a girl named Misako Kannabe. When they had first arrived at Pendle Hill, Misako sat by herself, separate from the group, watching everyone. Helen had tried to get to know her but the girl had retreated inside a protective shell and allowed her only to scratch the hard surface. All she knew was that the girl was from a country village outside Hiroshima, that no one else in her family or town had been disfigured the way she had, and that she had spent most of the postwar years in a back room making wigs and toupees by lamplight, preoccupied with the question of why she had survived when there was nothing to live for. Helen Yokoyama sensed that if she tried to direct Misako’s response she would resist and go the opposite way. So when Helen approached her she used the reverse strategy. “Misako,” she said, “you’ve heard of the sad event. It’s odd, but so many girls who are on the list way after you keep calling and saying, ‘This is the time when I can really show my gratitude to the doctors and let Mr. Cousins know we still trust him. Can you arrange it so I can come in next?’ And I told them to hold the line, Td have to ask Misako first. Your operation is slight, but still, you’re in a position to refuse. What should I say?”
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