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Pinpoint Beam

光線 (Kosen) by Kiyoko Murata

How does a man feel, Akiyama wondered, when his wife contracts cancer of the breast or uterus? It wasn't the degree of illness so much as the site of the organs. His wife's breasts and uterus were familiar from long association through their marriage; it wouldn't be the same if it were her lungs, stomach, or bowel. Her examinations at the hospital made him miserable. His own body was connected to hers at the tip, and he couldn't help feeling a dull ache in response. A month and a half ago his wife had gone to the hospital with symptoms, and the doctor suspected uterine cancer. An ultrasound test revealed abnormal thickening of the uterine wall. The area was scraped on all sides with a curette and cells were sent off for biopsy. The results would be known in a week. Either it was the lightest, precancerous stage, or the thickening had turned cancerous, in which case the degree of uterine wall penetration would have to be determined. If it were precancerous she would undergo a partial hysterectomy, and if the penetration were under five millimeters, they would remove her uterus along with the ovaries and fallopian tubes. If the tumor had burrowed five millimeters or more into her flesh, there was risk of metastasis, so she would undergo a pelvic lymphadenectomy?surgery to remove lymph nodes to see if they contained cancer. The lymph nodes in the groin were thick. Their removal would be sure to impact her daily life. There was no escape. Once before, a polyp had been easily removed, so that morning she'd set out unconcerned, only to return in the afternoon as white as a sheet. She'd sat at the dinner table and burst into tears. It wasn't that she was sad. It was a shock wave. Her conditioned response, if that was the right term, resembled hiccups. Akiyama had watched his wife in silence, at a loss for words.

But though the results were unfavorable, this still constituted early detection, and even if penetration were five millimeters or more, if the whole tumor was removed the five-year survival rate was eighty percent, death still rather remote. Falling within the fatal twenty percent would just be bad luck. Faced by the twin hurdles of surgery and life after the excision, his wife had hiccupped. Akiyama thought idly of the organs that would be removed. When he was young, to him his wife had been her body. Of course she'd also had compassion and kindness and spirit, but in the early days of their marriage when physical desire was red-hot she had been breasts to him, and uterus. Then she bore children and began to be occupied with childcare, while he in the prime of his working life had put his career first, her body's insistent reality gently fading along with her maternity. Once the children were grown she'd gone through menopause, her spirit overshadowing her body all the more. But her breasts and uterus hadn't gone away; it seemed rather that, their work now done, they had entered on a period of rest. 

A week later when she went to hear the biopsy result, she was told no cancer cells had been found. The thickening lay deep within the uterus, too far for the curette to reach. Without anesthesia, the procedure was quite painful. The doctor inevitably held back in sympathy. In the end it was decided she would spend two nights in the hospital and undergo exploratory surgery, laparoscopic enucleation with anesthesia on the lower body. She didn't want him coming to the hospital; instead her younger sister, who lived in a neighboring town, would take off work and go to the hospital that day. At night Akiyama realized his wife's cell phone lay forgotten on a kitchen shelf. With her surgery scheduled for the next day she wouldn't be needing it, but the day after that she'd be coming home and would need the phone to contact him. He pocketed the phone, got in his car, and went to the hospital to give it to her before the day ended. It must have been around eight o'clock when he arrived. Her room was directly in front of the nurses station, and his sister-in-law was standing in the corridor. He showed her the phone he'd brought and started to go into the sickroom, when from behind the nurses' station came the moan of a woman in pain. It seemed to be the voice of his wife. Apparently there was an examining room behind the station for the use of the ward. Low moans filled the nighttime corridor.

"What's that?" "They're not going in easily," his sister-in-law mumbled. Three instruments had been inserted to dilate the cervix over the course of the night. In the daytime they would slowly remove those instruments one by one and insert three new ones the same way. The sound of suffering went on. Didn't they use anesthesia, he asked. "Dilating the cervix is a common procedure for any curettage," she said, "and no, they usually don't use anesthetic. The cancer has probably caused the muscle to atrophy." This sister was a pharmacist. Between the moans came the warmly sympathetic voice of the woman doctor, who apparently believed it was better for the patient's health to use as little anesthetic as possible: "I'm sorry. Almost done. Go ahead and yell, it's okay." Feeling as if hot tongs were being applied to a part of his body, Akiyama handed the cell phone to his sister-in-law and went back down the corridor.

The next day an emergency case came in, so the surgery started four hours late, ending in an hour and a half at just after nine in the evening. After his sister-in-law called he went to the hospital, and the doctor came in with a glass vial containing the tissue she'd removed under the laparoscope. The three of them looked at it, his still-groggy wife, Akiyama, and the sister-in-law. It looked like bloody minced meat. "It was cancer, after all," said the doctor. All this tissue, from a uterus the size of a hen's egg. It seemed like a lot. "Did you get it all?" his wife asked. "Not yet," said the doctor, smiling, her cheeks still flushed from the work she had done. "Next time I'll go in abdominally and scrape it all out." A surgery was a truly physical, utilitarian sort of place, Akiyama thought. When the anesthesia wore off, his wife, who hadn't eaten anything since the day before, began to tear off little pieces of a soft steamed bun her sister had brought and eat them, flat on her back. Amid the faint, sweet smell, he thought of the granular lump of flesh in that glass vial. They talked of this and that, and eventually the nurse came in to disinfect the wound. His wife handed the remnants of the bun to her sister, and Akiyama and the sister went out into the corridor. He drove her home and then went back to his house. It was late at night on March 13, 2011.

After a bath he poured himself a cup of sake and switched on the TV. The screen was covered with images of what looked like piles of sawdust. This was what remained after the tsunami and earthquake that had struck off the Sanriku coast at two forty-six in the afternoon on the eleventh, two days earlier. Here physical reality was an enormous accumulation of debris. Not sawdust, but the wreckage of houses that had collapsed in the earthquake and tsunami. Since the disaster, he left the TV on when he was at home, but as events overlapped with the goings-on related to his wife's cancer he hadn't had much chance to sit down and take a good look. Yet ever since the eleventh, second by second these images had been running through his mind in synch with the events befalling his family. In his wife's brain, too, surely images of the calamity that had overtaken her flickered alongside images of this disaster. The scene changed, showing a panorama of the Fukushima Daiichi Nuclear Power Plant. White buildings stood against a backdrop of blue sea. Attractive scenery, viewed from a distance. This would be video shot the previous day, the twelfth, around three thirty in the afternoon. Huge clouds of white smoke quickly rose and enveloped the surrounding buildings. That was the moment when the first reactor exploded. The live screen reverted to the original scene. Again white smoke rose and enveloped the buildings. Back to the original scene. Again white smoke rose....

(Translated by Juliet W. Carpenter)