Dr. Nagai died on May 1, 1951, at the age of forty-three. Twenty thousand people attended his funeral, packing the interior of Urakami Church and the rubbled fields all around. A close friend rang one of the church’s famous bells, still temporarily mounted on a wooden platform outside the church. Several days later, huge crowds assembled again at Sakamoto International Cemetery, where Nagai was buried beside his wife, Midori, in the hills overlooking the Urakami Valley.
He left behind a generation of Nagasaki Catholics, many of whom believed, in the words of one survivor, that “God dropped the atomic bomb on Urakami as a test of love and forgiveness.” Another said, “It was good that the bomb dropped on Urakami. If it had dropped on people without faith, they could not have borne the burden.” Nagai also influenced the lives of non-Catholics: In 1978, thirty-three years after the bombing, a Japanese man told Catholic missionary Paul Glynn that Nagai’s writing, which he had stumbled upon in a public library, had changed his life. The man had been enraged with Japan’s leaders and his wartime teachers who had brainwashed everyone into believing that Japan was a divine nation that could never be conquered, and he agonized that perhaps “human effort and personal values were ultimately meaningless.” Nagai’s writings persuaded him to convert to Christianity and believe in a God “who is always good, even though it may not appear so in the short term.”
Dr. Nagai Takashi, ill with leukemia, inside his tiny hut built for him by members of the Urakami Church congregation, August 1949. (Bettmann/Corbis Images)
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Nagai was not without his critics, however. Dr. Akizuki, a former student of Dr. Nagai’s, adamantly opposed Nagai’s views and believed that his message—that the people of Nagasaki had served as sacrificial lambs to God for the sake of peace—minimized and silenced the survivors’ suffering, provided a rationalization for the United States’ use of the bombs, and gave credence to the existence of nuclear weapons. Raised a Buddhist, Akizuki had also explored the Bible and other sacred texts, and he could not believe in a God whose will and divine plan allowed the suffering he had witnessed after the atomic bombing. The barely five-foot-one doctor often challenged hibakusha nuns at his hospital about their beliefs. “Why is it that you have to suffer like this?” he demanded. “Why people like you, who’ve done nothing but good? It isn’t right!” Unshaken, the Catholic sisters replied that they believed in providence, in the will of God. But Akizuki could not agree. He blamed the Americans for dropping the bomb and hated the Japanese government “who had willfully perpetuated this senseless war.”
Still, Akizuki’s perspectives on the bombing and its grim aftereffects did not offer him a deeper meaning that could help him cope with the surreal horror he had witnessed. After more than two years of caring for injured and irradiated survivors, he found himself physically and mentally depleted, and overwhelmed by a penetrating anxiety and a sense of emptiness. Standing at a hospital window overlooking the scorched atomic ruins, he decided to leave the city in order to reclaim a quiet life and cleanse himself of the grimy “victim of war” mentality that plagued him. “I protected this place by giving up everything,” he thought, “but now it’s time for me to go.”
Before his departure, he visited his former mentor, Dr. Nagai. Inside Nyokodo, Akizuki sat on the tatami mat next to his friend, who lay on a futon, extremely pale and his stomach bloated as a result of the leukemia. Akizuki told Nagai that he felt his heart “was covered with weeds” and that he could no longer tolerate staying in Nagasaki. “I want to leave Urakami,” he said. “I want to clean my mind.”
In March 1948, thirty-two-year-old Akizuki placed a few items of clothing and some small possessions into a willow basket and left First Urakami Hospital. Boarding a train, he headed twenty-two miles northeast of the city to the rural village of Yue, where he had studied agriculture in high school. At the foot of Mount Taradake, he rented a single room inside a grilling shack behind a farm, where he planned to rest, write, and improve his health by following a diet of brown rice, seaweed, and sesame seed salt as an alternative to traditional medicines.
Akizuki’s life was tranquil at first, enveloped in fresh air, sunlight, and the green of the mountain. He began his new diet, recorded its effects on his health, and wrote a thirty-page essay titled “A Week Covered with Blood,” documenting both the horror of Nagasaki and the courageous work of his colleagues during the first seven days after the bombing. But his life took an unexpected—and unwanted—turn when the people of Yue discovered that a doctor lived in their midst. Every day, sick villagers arrived at his door, and despite his longing for rest, Akizuki could not turn them away. The stethoscope he had brought with him to monitor his own heart became an instrument for treating the local villagers, and he took the limited amounts of medicines he had brought with him and divided them into small doses for patients with colds or stomach pain.
In return, the villagers cared for Akizuki, felling trees, constructing a small house and clinic for him, and insisting—against Akizuki’s protests—that he find a nice wife. Upon reflection, Miss Murai Sugako came to his mind, a young woman who had assisted him in a medical procedure at the moment of the bombing and had worked by his side ever since. Dr. Akizuki sensed that Sugako might understand his way of living, thinking, and searching for meaning.
He invited her to visit him in Yue, and as they stood together on top of the mountain with the Ariake Sea in the distance beyond, Sugako resolved to marry him. Following a tiny marriage ceremony in Nagasaki, they returned to Yue for a rustic reception the villagers held for them. Soon, after much anxiety over the impact of their radiation exposure on their unborn child, Sugako gave birth to a healthy baby girl.
During his five years in Yue, Akizuki had succeeded in improving his health, had written and published short works on the atomic bombing and alternative food therapies, married, and had a child. Still, he longed for the quiet life he had never achieved. They never had enough money to pay for even their basic living expenses, so Sugako attended to patients in their home clinic. They rarely had time to share a meal together. As Akizuki rode his bicycle on bumpy, muddy paths between rice fields to the homes of sick villagers, he grumbled to himself that he “hadn’t come all the way to Yue to live like this.”
Then in the spring of 1952, Dr. Akizuki’s chronic asthma worsened and the tuberculosis he had experienced nine years earlier recurred. He felt he had no choice but to return to Nagasaki with his family. The First Urakami Hospital on Motohara Hill was now run by sisters of the order of Saint Francis, whose head offices were located in Springfield, Illinois. Renamed St. Francis Hospital, the rebuilt and newly equipped facility was again fulfilling its earlier purpose as a tuberculosis sanatorium. While receiving medical treatment, Akizuki resumed his work there.
Dr. Akizuki Tatsuichiro, age seventy-four, at St. Francis Hospital, ca. 1990. (Courtesy of St. Francis Hospital)
In an unusual twist, Akizuki converted to Catholicism in 1953. His motivations remain somewhat unclear; he later hinted that he felt isolated as a Buddhist working at a Catholic hospital, surrounded by daily masses, hymns, and nuns who prayed for his conversion, and he said that he appreciated the profound support his Catholic friends and colleagues derived from their faith. He also admired their dedication, commitment, and self-sacrifice in almost single-handedly rebuilding the hospital—even before their own houses were reconstructed and while their family members lay sick and dying at home. After his conversion, however, Akizuki remained ambivalent toward his religion. “If this hell day came to me again, and the atomic bomb burned us up again,” he said, “would Jesus Christ save us?”
As he searched for the deeper meaning of his survival and a potent way to support the healing of others, Dr. Akizuki came to believe in the immense power of personal story as a means for individual and social transformation. Over the next forty years, Dr. Akizuki forged a life of activism and became one of Nagasaki’s leading
advocates for hibakusha to articulate their atomic bomb experiences in writing and in oral presentations. His efforts offered survivors new ways to heal their psychological trauma while also heightening international understanding of the effects of nuclear war and furthering the cause of eliminating nuclear weapons arsenals across the globe. Akizuki wholeheartedly believed that had Dr. Nagai lived longer, his perspectives and teachings on the atomic bombing would have changed over time to include the unequivocal denunciation of nuclear war.
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For countless hibakusha, trying to understand their new identities as atomic bomb survivors included coping with chronic health conditions and the inability to fully recover from their injuries, burns, and radiation-related conditions. Slow recovery was often a result of high doses of radiation that had destroyed regenerating cells and damaged their natural defense mechanisms. For many, postsurgery scars did not heal and developed infections. Large numbers of hibakusha—particularly those exposed within 1.25 miles of the hypocenter—also complained of various unclassifiable symptoms, including bouts of extreme dizziness, lack of mental energy, numbness, and incapacitating fatigue.
Numerous new health conditions also emerged. Cataracts, the clouding of the eyes’ crystalline lenses, were so frequently diagnosed that for a time they were called atomic bomb cataracts, caused by radiation damage to cells on the back surface of the lens. Researchers later determined that the incidence and severity of survivors’ cataracts correlated to their age and estimated radiation dose. Microcephaly—a condition defined by a significantly smaller-than-average head size in proportion to a child’s body, reduced life expectancy, and decreased brain function—occurred in approximately 15 percent of children exposed to radiation in utero up to 1.25 miles from the hypocenter, a rate almost four times higher than for those not exposed. Other intrauterine-exposed infants were born with brain damage that resulted in mental retardation or other developmental disabilities. Many hibakusha—like Yoshida’s father in 1946 and Nagano’s father in 1948—died prematurely for unknown reasons or from conditions their families believed, but could not confirm, were caused by radiation exposure. Although the high mortality rate of their patients alarmed them, Nagasaki doctors remained cautious in attributing radiation exposure to survivors’ unexplainable conditions and deaths until further studies were conducted.
Some diseases, however, were accurately ascribed to radiation toxicity, first by informal observation and later by documented research. After a period of latency, in 1947, physicians began observing increased rates of childhood and adult leukemia among hibakusha—and these rates swelled in the years that followed. Later studies confirmed disturbing figures: Depending on shielding, hibakusha exposed within three-quarters of a mile from the hypocenter were up to six times more likely to develop leukemia than those not exposed, and people exposed within a mile and a half of the hypocenter faced double the risk compared to those not exposed. At highest risk were children under ten within a mile at the time of the bombing, who developed leukemia at a rate eighteen times greater than the general population. Children ages ten to nineteen followed, with an incidence rate eight times higher than average. Autopsies continued to reveal the severe internal damages radiation had caused to survivors’ bodies. One young man, twenty-eight years old and healthy at the time of the bombing, became more and more sick in the years after the war and was eventually diagnosed with leukemia. He died in 1950. In their autopsy report, doctors described the man’s internal organs as “black and pulpy, like coal tar.”
Other malignancies also escalated, including cancers of the stomach, esophagus, larynx, colon, lung, breast, thyroid, uterus, ovaries, bladder, and salivary glands. Later analysis of their medical records confirmed that hibakusha exposed to radiation within approximately three-quarters of a mile were 40 to 50 percent more likely to develop cancer than those not exposed. Physicians who knew the details of how these cancers manifested remained exasperated and furious with occupation censorship policies that had blocked them from speaking publicly about their cases. Grieving family members and friends felt intense bitterness and outrage. Fear of illness and death never ceased.
Brutal private and social stresses persisted as well. As with Nagano’s painful emotional distance from her mother, many families remained shattered by blame and guilt. Children with visible injuries and hair loss were taunted by their uninjured schoolmates who called them “one-eyed devil,” “chicken leg,” “baldy,” “monster,” “atomic bomb,” and “tempura”—the last referring to Japanese deep-fried shrimp and vegetables. Some microcephalic children were blocked from enrolling in elementary school or participating in school sports and extracurricular activities. Inaccurate rumors circulated that one could get atomic bomb illness by touching a survivor.
Even young children without physical injury or illness experienced ongoing distress. One day in her second-grade Japanese literature class, a Nagasaki teacher led her students in reading and discussing a popular story about five children growing up together with the loving care and support of their parents. A small girl raised her hand. “These children are really happy, aren’t they?” she asked, her voice filled with melancholy. The teacher quickly remembered that the parents of this girl and many others in the class had died in the bombing, and she marveled that even she, who spent every day with them, could so easily forget the depth of their losses. During the lesson, some children would not look at the blackboard where the words “mother” and “father” were written. Others bit their lips, scribbled in their notebooks, or gazed blankly out the window.
Adolescents like Yoshida with visible disfigurements remained constantly vigilant of people’s stares, looks of disgust, and degrading comments, and many rarely ventured from their homes. Yoshida credited his mother’s love for keeping him going. She came to him one day and told him that she understood how he felt—more than he knew—and she asked him to listen to her for just a moment. “You can’t stay inside the house your whole life,” she told him. “I know you don’t want to do it. I know it’s sad for you. But do you think you could practice walking just around the neighborhood?”
“No!” Yoshida yelled at her. Eventually, however, he decided to take his mother’s suggestion and go walking outside—first to the shrine, three houses away, where he thought he wouldn’t run into many people. “The first day I walked a hundred yards,” he remembered. “The next day, one hundred and fifty yards. A little bit farther each time.” He avoided children because they stared at him without reserve. “I was too scary to look at, but they looked anyway.” Yoshida was crushed when he said hello to a pretty girl and she started to cry. One day, as he walked toward a group of mothers, he saw their expressions of disgust and revulsion before they turned their faces away and walked past him. Yoshida started to cry, but he kept moving forward. Keep calm, he whispered to himself, tears streaming down his face. Don’t look back. Don’t look back!
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For physically able survivors, returning to work played a major role in their recovery, but finding a full-time job was particularly difficult, in part because few were available, and also because employers repeatedly rejected hibakusha out of fear of survivors’ current and future health issues. Many survivors resigned themselves to day labor as fishermen, farmhands, or construction workers. Even those without observable injuries began hiding their hibakusha status from current and prospective employers—and those with jobs did everything they could to keep them, showing up to work even when extremely ill.
For twenty-year-old Nagano, finding employment as a shop clerk allowed her to step out of her gripping loneliness at home. Later, she worked as an aide in the facilities department at Nagasaki Medical College. In the small wooden hut where staff designed the rebuilding of the college, Nagano made tea, did the filing, and helped with odd jobs.
Yoshida, now eighteen, felt so compelled to help support his family that he hazarded people’s derisive looks to work as a par
t-time manual laborer at his neighbor’s furnace shop. Eventually, he secured a full-time job in the warehouse of a small wholesale food company. During the first year, he was able to improve his abacus skills and study the kanji for each food item while staying out of public view. After that, Yoshida was assigned to work directly with customers. He tried to understand their feelings as they stared at him—You can’t make a good first impression without a good-looking face, he told himself—but every day was unbearable. “I cursed the war and the atomic bomb,” he said. “Why did my face have to be burned? Why hadn’t I been allowed a chance to protect myself?”
Yoshida Katsuji, age nineteen, in wholesale food company uniform, ca. 1950. (Courtesy of Yoshida Naoji)
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Do-oh was twenty and in her fifth year sequestered inside her house when new hope finally appeared at her door. It was 1949, at the time of year, she remembered, that “the persimmon fruits started to develop color.” Her injuries still hadn’t fully healed, and her hair had not grown back; short, soft fuzz still grew in periodically, then fell out again. “I felt like giving up,” Do-oh remembered. “At about that time, an unfamiliar, foreign car arrived and parked in front of our house.
“‘I have come from the ABCC to take you there,’ the person told us. ‘Please cooperate with our research.’ I got into the car believing that I would be healed by them.” Driving away, Do-oh stared out of the car window at the city she had not seen since the bombing. She had no idea of the underlying purposes of the medical examination she would undergo that day or the intense international dispute in which she would play a small part.
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